Volume 3 Issue 9: Industry News

New Partnership Aims to Launch Employer Bundled Payment Programs

By: Les Masterson


Dive Brief:

  • The National Alliance of Healthcare Purchaser Coalitions, a nonprofit network of business coalitions that includes more than 12,000 purchasers covering 45 million Americans, is partnering with Remedy Partners to create bundled payment programs.
  • The initiative is looking to build a national platform of episode-based payment and benefit design for employers to test over the next year.
  • Michael Thompson, CEO of the coalition, said the purchasers are looking to take advantage of Remedy Partners’ bundled payment knowledge. The goal is to create risk-based arrangements that employers can replicate.

Dive Insight:

Employers are increasingly looking for ways to improve value, quality and care coordination and reduce healthcare costs. They are banding together in groups like the National Business Group on Health, Catalyst for Payment Reform and the Pacific Business Group on Health.

These groups are looking for ways to contract with providers that reward quality. The initiatives include accountable care organizations for an entire employee population and bundled payment carve-outs or Centers of Excellence.

Walmart is one major employer with a COE. The program provides care to employers in a value-based payment program. There are no out-of-pocket costs, and while patients may have to travel to receive care, the program covers all travel-related costs. Walmart is offering a COE for employers in need of spinal and joint replacement surgery.

This trend will likely intensify in the coming years. A 2017 Willis Towers Watson report said employers expect healthcare costs will increase 5.5% this year after a 4.6% increase in 2017. In response, employers in the survey said they’re increasing cost-containment strategies.

Another recent Willis Towers Watson survey found that only 6% of employers contract directly with providers now, but 22% are considering it for 2019.

Thompson sees potential in such efforts. “Employer-led bundled payment can truly bring about the change required in the broken healthcare market. Working through our regional and national network of member coalitions can enable faster and more seamless execution of episode of care payment models across the country,” he said.

Rising employee medical costs are what drove Amazon, J.P. Morgan and Berkshire Hathaway to create a new healthcare company. It’s not clear what exactly the company will do, but with such big names behind the joint venture and the recent announcement of Atul Gawande as CEO,  it could certainly make waves.

“Hospitals, clinicians, and health plans will want to closely monitor the new company, especially if it shows any signs to eventually expand efforts beyond the founders’ employee base,” Rob Lazerow, managing director of research at Advisory Board, recently told Healthcare Dive. “The sophistication of these companies, their significant financial resources and their ability to disrupt established markets is clear.”

Healthcare purchasers aren’t waiting around to follow Amazon’s lead, as this new partnership shows. Employers are hoping that through collaboration they will figure out ways to improve care and bend the cost curve.

To view the article, click here.


CMS Gives Providers Another Week to Decide Whether to Jump into BPCI Advanced

By: Susan Morse

Healthcarefinancenews.com – The Centers for Medicare and Medicaid Services has delayed by a week the deadline for healthcare organizations to decide whether to  participate in the latest episode payment model, the Bundled Payments for Care Improvement Advanced.The original due date to submit signed participation agreements was August 1. It is now August 8.

BPCI Advanced qualifies as an advanced alternative payment model under MACRA’s quality payment program, giving participants the ability to both take on risk and to reap any savings rewards.

The American Hospital Association had requested a delay in implementation, citing a lack of operational detail, especially over target pricing.

Many applicants did not receive their data until well into June and others have yet to receive it, the AHA said in a June 21 letter to CMS.

Participants in the program are still expected to be announced in September.

CMS reported high interest in the bundled payment program.

In February, CMS urged hospitals to apply by the March deadline and to wait for further target pricing information to make up their minds by the August deadline.

To view the article, click here.


HHS Launches New Initiative to Address Health Concerns as National Security Threats

By: Paige Minemyer

FierceHealthcare.com – The Department of Health and Human Services has launched a new initiative that aims to accelerate innovations for addressing systemic health concerns with a similar approach that’s been taken for addressing manmade health threats.

To view the original article in its entirety, click here.


Health Care Costs for the Typical Family of Four Top $28,000 this Year, Despite Slower Increases

By: Guy Boulton

Jsonline.com – Health care costs have been increasing at the lowest rate in the past two decades. The result?

The total costs for a typical family of four insured by the most common health plan offered by employers will top $28,000 this year, according to the annual Milliman Medical Index.

To view the original article in its entirety, click here.


FDA to Call Out Brand Name Drug Companies That Blog Generics

By: Robert King

WashingtonExaminer.com – The Food and Drug Administration will publish the names of companies that have been blocking generic competition on a new website in an effort to clamp down on efforts by brand name drug companies to keep prices high.

To view the original article in its entirety, click here.


HHS Secretary: We Need to Drive ‘Broader Change’ in Health Price Transparency

By: Paige Minemyer

FierceHealthcare.com – When HHS Secretary Alex Azar had a routine echocardiogram turn into a hospital admission several years ago, it became a firsthand lesson in how hard it is to get accurate pricing data.

To view the original article in its entirety, click here.


Sitting Tied to Raised Risk of Death From 14 Diseases

By: Steven Reinberg

Consumer.Healthday.com – Get up off of the couch: Sitting too much may kill you even if you exercise regularly. If you sit for six hours a day or more, your risk of dying early jumps 19 percent, compared with people who sit fewer than three hours, an American Cancer Society study suggests.

To view the original article in its entirety, click here.

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