Accountable Care

Once bitter rivals, healthcare providers in same markets are finding it's better to keep their enemies close, sharing services, health plans and purchasing power among them.

A former advisor to President Barack Obama is warning healthcare providers to embrace bundled payments as accountable care organizations fall behind in reaping savings from value-based payment models.

"There can be a snowball effect, where you have more and more costs that often could have been prevented by just doing better primary care." - James A. Colbert, MD, Instructor in Medicine at Harvard Medical School.

With Aetna's market share set to balloon next year after its takeover of Humana wraps up, the insurer is trying to assuage health systems that might fear greater reimbursement pressure.

Presbyterian Healthcare Services, an integrated delivery system with eight hospitals, 700 physicians, 100-plus clinics and a 300,000-member health plan, will take on care coordination and prevention for more than 12,000 members in UnitedHealthcare's employer-sponsored plans in New Mexico.

"The very advantage of telehealth, its ability to make care convenient, is also potentially its Achilles’ heel."

The best method to attract and keep consumers is to build access to points of care throughout the organization, from a hospital's retail clinic to physician offices, primary care and medical specialists, experts at HFMA 2015 ANI say.

Speakers at the Healthcare Management Association 2015 Annual Institute warn providers to embrace models like capitation, accountable care and bundled payments.

Healthcare Finance will be on the ground at the conference and will file live reports from the sessions.

Lancaster General Health Community Care Collaborative will be accessible by the payer's Medicare Advantage members in the Pennsylvania region.