NEWSLETTER — Community Health Plans: Prioritizing Value

ACHP plans are standing with their provider partners, providing critical support to help ensure continued access to essential care. The COVID-19 public health emergency continues to impact all corners of the health care industry– particularly providers and health care facilities that have seen dramatic reductions in volume as patients choose to delay care.

The nonprofit, community-based members of the Alliance of Community Health Plans (ACHP) collaborate closely with local providers to offer coordinated, high-quality coverage and care. In these uncertain times, ACHP plans are standing with their provider partners, providing critical support to help ensure continued access to essential care. For example:

  • Independent Health pivoted to an all-encompassing global payment system for providers when their fee-for-service revenue began to plummet. The health plan is exploring how to continue this payment type even after the pandemic with a continued focus on value.
  • Intermountain Healthcare is guaranteeing its contract-based providers receive no less than 85 percent of their current pay no matter how many patients they see. The system is also redeploying employees to areas of need to continue to support them.
  • PacificSource is offering a stability payment program for providers serving members enrolled in its coordinated care organizations who predominantly receive fee-for-service reimbursement.
  • Priority Health is helping combat maternal care disparities by offering financial incentives to providers who transition to the Centering Healthcare Institute’s (CHI) CenteringPregnancy value-based care model. The approach lowers overall health care costs while improving patient outcomes and satisfaction.
  • Harvard Pilgrim Health Care is financially assisting independent primary care practices in reopening, supporting community health centers in efforts to advance equity and equality in accessing health care, and providing $40 million in advances to providers in the region.
  • CDPHP is working in lockstep with their provider partners and offering assistance to keep practices solvent, particularly with global payments for primary care providers that are not financially affected by a decrease in patient visits.

The global health emergency is highlighting the pitfalls associated with fee-for-service payments and underscores the need for a shift to value-based care.  The value-based contracting between many ACHP health plans and their provider partners has proven to be an important stabilizing factor during this time. By prioritizing value, health plans and providers can work together to innovate and deliver the best care where and when patients need it – driving down costs and improving health outcomes. Now is the time to embrace the shift and prioritize high-value coverage and care patients deserve.

Additional information on efforts of ACHP plans and their affiliated systems during this public health crisis is available here.

Please contact Dan Lemle with any questions.