Everyone wants the best health care possible. But cost — premiums, deductibles, copays and any other expense to the individual — is also a key factor. Health plans such as BlueCross work to balance these considerations every day for our members, giving them access to the care they need at a cost they can afford. One way we do that is by contracting with providers — doctors, hospitals, clinics, etc. — to create health care networks. By agreeing to join, providers accept negotiated discounts from their standard billing rates. Every network is, then, a “value” network because it saves our members money. In recent years, as a response to consumer demand for more affordable coverage options, insurers have developed new,… read more
In the shift from a fee-for-service to a fee-for-value health care environment, three Indiana hospitals are leading the charge by creating clinically integrated networks to better serve their patients. In Columbus and Seymour, adjacent communities hugging Interstate 65 in south central Indiana, leaders of two hospitals and their associated physician groups have formed Inspire Health Partners, a clinically integrated network to change both the structure and mindset of health care. That includes breaking the tradition of doctors being focused on a small number of patients each day. “We’d like that doc to wake up every morning and say, ‘I have 2,500 families that I have to keep healthy,’” says Marc Rothbart, president of Inspire Health Partners. Meanwhile, in a 20-hospital… read more
Achieving the goals of accountable care—better coordination, improved outcomes, lower costs—requires a robust health information technology infrastructure and the ability to analyze large volumes of patient data. Modern Healthcare New York Bureau Chief Melanie Evans moderated a discussion with Jason Dinger, CEO of MissionPoint Health Partners, a Nashville-based subsidiary of Ascension that focuses on accountable care; Kim Kauffman, vice president of value-based care at Summit Medical Group, a 220-physician group based in Knoxville, Tenn.; and Katie White, assistant professor of health policy and management at the University of Minnesota School of Public Health. This is an edited transcript of that discussion.
Leslie Duke, a retired Ford auto worker and full-time putterer, fell in his basement while working on his antique tool collection. He couldn’t remember what happened. He suffered brain damage and spent six weeks in a hospital in Nashville, Tenn. When he went home, friends greeted him with warm wishes and gifts. They returned for more visits. Then the visits dropped off. “After a while, people stop coming. They forget,” said his wife, Odessa Duke. Enter the Rev. Catherine Chang, chaplain for MissionPoint Health Partners, an accountable care organization. MissionPoint advocates for patients, some of whom have chronic illnesses, after they are discharged from traditional hospitals. Its nurses and counselors make home visits, help patients navigate the health care system… read more
MissionPoint Health Partners, an Ascension subsidiary that develops health plan networks and accountable care organizations, is going after employers’ business in Alabama, Indiana and Florida. An increasing number of health systems are negotiating directly with employers as they compete for local market share. They also risk alienating insurance companies that they still need to negotiate with for other business. Healthcare executives say the strategy allows them to better control healthcare cost and quality by using narrow provider networks that use information technology and incentives to coordinate care. Insurance companies that administer health plans for large employers are important, said Jason Dinger, MissionPoint’s chief executive. MissionPoint will work with employers’ existing insurers to add the MissionPoint benefits and network as another… read more
MissionPoint Health Partners has teamed up with St.Vincent to further the company’s ministry of high-quality, holistic care – already helping 72,000 people in Indiana since the partnership began in Jan. 1. With this partnership, St.Vincent is applying MissionPoint’s Population Health Management model, which strives to see better patient outcomes, lower the costs of healthcare and improve patient satisfaction. The goal is to identify patients as people, not illnesses.
The economic and risk equations are shifting for midsized and small employers weighing whether to self-fund their benefits claims. “There are advantages for employers in self-funding, so we see the [growth] trend continuing, but largely among midsize and smaller employers, in the range of 100 to 1,000 covered lives,” says Brad Nieland, vice president of stop-loss at Sun Life Financial.
As the industry continues to focus on value-based care, the way healthcare workers engage with patients will also change. This means many clinicians need training on how to treat patients based on their overall needs and not solely on their disease or condition.
Work in health care remains very complex. It takes innovation and continuous, rapid learning in order to ensure success over different geographies, populations and disease states such as diabetes, chronic heart failure and other chronic conditions. That means failures must come quickly and often, in order to lay aside what doesn’t work and ensure that the successful innovations are scaled quickly. Of the many lessons MissionPoint has learned during the last three years, the most important was to stay curious and listen deeply for what resonates with members and providers.
The organization is banking on an unseen component of healthcare: the patient’s spiritual well-being. This year, the local market began offering a chaplain, a model its chief medical officer says will keep pace with MissionPoint’s growth into more markets.