U.S. healthcare providers and insurers start from widely divergent places as some of the largest move to put most of their business into payment models that reward lower cost and higher quality care.
A new task force made up of providers, insurers and employers has committed to shift 75% of its members' business into contracts with incentives for health outcomes, quality and cost management by January 2020.
“We're making a public commitment together, all four segments, providers, patients, payers and employers, all of us saying we're going to work together to accomplish this goal,” said Dr. Richard Gilfillan, chairman of the task force and CEO of Trinity Health, a not-for-profit health system that operates in 21 states. Gilfillan is also former head of the CMS Innovation Center, which was formed under the 2010 federal health law to test new ways to finance and deliver healthcare.
The Health Care Transformation Task Force also includes Ascension, based in St. Louis, and insurance giants Aetna and Health Care Service Corp. Employer Caesars Entertainment Corp. and the Pacific Business Group on Health also are involved.
Their announcement follows similar pronouncements in the last year by individual private and public payers, including by Medicare this week.
The members have surveyed the percentage of existing business under similar contracts, but Gilfillan declined to provide details. On average, he said, 30% is under accountable care, bundled payments or other similar contracts. But there is a wide spectrum, he said, and Trinity Health is below the average. “We have a long way to go and it's a real stretch,” he said.
Gilfillan said the task force members are committed to revamping how hospitals and doctors are paid even if they're not entirely sure how to do it. “We go out and we set ambitious goals that are consistent with our commitment to the great healthcare providers and we don't know everything we need to know about how to get there,” he said.
Dignity Health, another large not-for-profit system, has roughly 15% of its business under accountable care or alternative contracts. “It's a huge, audacious goal, but one that we think needs to be achieved,” Dignity Vice President Shelly Schlenker said.