Another quote from an executive vice-president of one of the systems really captured my attention: “We are clearly gearing up to change directions from a traditional fee for service for what he calls “payment for value”. I think I have heard this called “outcome based” compensation in the past.
They give several examples of how a medical home appears to resonate with employees and in the city described in the article that early results show promise: “patients enrolled in medical homes had 3.5 percent fewer visits to emergency room and 14 percent fewer hospital admissions.” They are asking an outside firm to do a more detailed analysis.
They report that some companies have decided to send at least some of their folks to the new “public exchanges”; I am not sure about how public the so called “public exchanges” are because the rumor is out that they are outsourcing some of the running of some of these exchanges. The reason for sending some of their folks to exchanges with a monetary contribution to buy policies is that because of employees’ low incomes they believe they will be eligible for federal subsidies to buy coverage.
A few of the larger major employers are aggressive in trying to change how health care is delivered in this country. They are looking to make direct connections with health systems with institutions that can deliver care for expensive procedures. The company described in the article signed agreements with a high-volume orthopedic hospital, to oversee the care of some employees getting hip and knee replacements. Another large company reportedly contracted with Cleveland Clinic, Mayo and Geisinger, among others to take care of transplant, heart and spine care with plans to extend to other centers of excellence.
The article reports that this doesn’t sit so well with some local providers, but the large company primarily focused in the article is unapologetic and states they will continue to try a variety of approaches until it finds a way to tame health care cost.