BEI HIT Blog
Bloomberg.com, February 9, 2012
BEI Commentary: Not only is Medicare focused on Fee-For-Value programs (also called outcomes based payments), United Health is getting in the game as well. Perhaps even more surprising is the fact that United says that up to 70% of its members will be covered by some type of FFV plan by 2015. EHRs will play a key role in allowing physicians to participate in an FFV program.
UnitedHealth Group Inc. (UNH), the largest U.S. health insurer by sales, will pay doctors based on the quality of their care in a cost-cutting effort that also benefits the company’s consulting business.
UnitedHealth expects to save twice as much as it would spend on incentive payments for doctors because patients will be healthier, according to company documents forwarded by spokeswoman Cheryl Randolph. The program may cover as much as 70 percent of the insurer’s commercial members by 2015, from less than 2 percent now, the company said.
The nationwide expansion of the program follows similar efforts by the U.S. government and rival insurers to trim medical costs by shifting away from paying based on the amount of services provided. Optum, UnitedHealth’s services business, will be able to sell software, data and consulting to providers making the changes, Sam Ho, chief clinical officer of the insurer’s UnitedHealthcare unit, said in an interview. Read more
Healthcare Economist, January 16, 2012
BEI Commentary: As we have said many times before, HIT will become an integral part of an ambulatory practice in the future, and will need to be well implemented in order to support the new P4P initiatives. Here is the first volley on this that we have seen from Medicare.
In 2015, Medicare will begin implementing a value-based purchasing (VPB) program for physicians. Initially the program will target only certain physicians and groups of physicians, but by 2017 all physicians is participate in this program.
The VBP program will evaluate physicians along two broad dimensions: quality and cost. In the final rule:
Section 1848(p) of the Act requires the Secretary to ‘‘establish a payment modifier that provides for differential payment to a physician or a group of physicians’’ under the physician fee schedule ‘‘based upon the quality of care furnished compared to cost *** during a performance period.’’ The provision requires that ‘‘such payment modifier be separate from the geographic adjustment factors’’ established for the physician fee schedule. In addition, section 1848(p)(4)(C) of the Act requires that the value modifier be implemented in a budget-neutral manner. Read More
Providence Business News, December 12, 2011
BEI Commentary: As has been borne out with other studies, a recently completed pilot by BCBS in Rhode Island over three years found significant decreases in health care spending and increased outcomes for physicians using EHRs. Even the physicians were pleasantly surprised.
The use of electronic health records in a three-year pilot program lowered health care costs by an average of between 17 and 33 percent, Blue Cross & Blue Shield of Rhode Island announced Monday.
In addition, EHR use was found to have led to improved quality outcomes, with a 44 percent median rate of improvement in family and children’s health, 35 percent in women’s care, and 24 percent in internal medicine in Rhode Island. Read More
