ARTICLE
11 February 2015

Task Force Of Healthcare Providers And Insurers Are Shifting To Incentive Based Contracts

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Sheppard Mullin Richter & Hampton

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Sheppard Mullin is a full service Global 100 firm with over 1,000 attorneys in 16 offices located in the United States, Europe and Asia. Since 1927, companies have turned to Sheppard Mullin to handle corporate and technology matters, high stakes litigation and complex financial transactions. In the US, the firm’s clients include more than half of the Fortune 100.
Some of the largest healthcare providers and insurers in the country have joined to form the Healthcare Transformation Task Force in an effort to change healthcare industry payment models.
United States Food, Drugs, Healthcare, Life Sciences

Some of the largest healthcare providers and insurers in the country have joined to form the Healthcare Transformation Task Force in an effort to change healthcare industry payment models.  The announcement of the task force and its efforts come shortly after the Department of Health and Human Services announced plans to overhaul Medicare's fee-for-service program and transfer non-managed care spending to contracts that incentivize quality performance and cost control.  A unified vision of shifting to incentive based contracts has brought together health systems, Ascension, Trinity Health, Partners HealthCare, and Advocate Health Care, insurance titans Aetna and Health Care Service Corp., and Caesars Entertainment and the Pacific Business Group on Health to form the Healthcare Transformation Task Force.  The goal of the task force is to transform 75% of their business contracts to incentive based contracts focused on improving healthcare quality and lowering healthcare costs.

Partners Healthcare's senior vice president for population health, Dr. Tim Ferris, stated that the focus of these efforts is alignment of payors and providers.1 The task force will not just work to develop new contracting methods focused on incentivizing providers based on quality and outcomes, but will also develop policy proposals focused on accountable care, bundled payments, and cost management aimed at reshaping the entire healthcare industry.

There is not enough evidence to say with certainty whether these efforts will achieve intended outcomes.  More data concerning accountable care and bundled payments is needed to determine which quality measures and financial incentives will be effective.  However, members of the task force are enthusiastic about the venture and will undoubtedly use their substantial market power and resources to achieve their desired goals of improving care, lowering costs, and enhancing the patient experience.

Footnotes

1.Melanie Evans, Major Providers, Insurers Plan Aggressive Push to New Payment Models, Modern Healthcare, January 28, 2015, http://www.modernhealthcare.com/article/20150128/NEWS/301289934

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