Win-Win Payments for Providers and Payers

Rene Letourneau, for HealthLeaders Media , September 26, 2013

Carter says he is the health system's executive leader and point person for the program, and Blue Cross has also designated a senior leader to take the lead in the partnership.

"We work together when issues come up. By assigning this to an executive level of the organization, we have elevated the trust that we have with Blue Cross. … It is very different than it was a year and a half ago, and it's an important element of being able to successfully create these types of arrangements with payers," Carter explains.

He says it is too soon to analyze results but notes that CHE Trinity Health leadership will base the program's success on factors such as improved quality indicators, lower total cost of care, and improved patient satisfaction relative to how care is delivered and with regard to access to care.

"We need to be in a position to assume responsibility for the vast majority of medical expenses and premium dollars," Sears adds. "Assuming such responsibilities aligns our interests to improve quality and reduce costs in ways that benefit individual patients and our communities."

CHE Trinity Health's arrangement with Blue Cross is just the beginning of the value-based contracts the health system plans to roll out.

"We are in active discussions with well over a dozen payers on similar kinds of relationships and are at varying levels of working those things through," Sears says. "We think this is a starting point. We ultimately think this will lead to even more significant vehicles for alignment. As a provider and delivery system, we need to be in a position to assume responsibility for the vast majority of medical expenses and premium dollars. The opportunities lie in creating better quality and costs relative to our individual patients and our communities."

Reprint HLR0913-9

This article appears in the September issue of HealthLeaders magazine.

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