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As Obamacare Looms, Insurers Look Beyond Fee-For-Service Medicine, Say Execs
The nation's largest health plans say they are rapidly moving toward transparency and away from paying doctors and hospitals on a fee-for-service basis, four insurance executives said this morning at Forbes Healthcare Summit 2013.
The nation’s largest health plans say they are rapidly moving toward transparency and away from paying doctors and hospitals on a fee-for-service basis, four insurance executives said this morning at Forbes Healthcare Summit 2013.
UnitedHealth Group (UNH), Humana (HUM) and several Blue Cross and Blue Shield plans represented at the summit say their efforts will be a significant step by those paying for health care in the U.S. to move further away from fee-for-service medicine that rewards treating illness to a system that pays doctors and hospitals to keep patients healthy.
“It is a fundamentally different way of practicing,” Gail Boudreaux, chief executive officer at UnitedHealthcare, subsidiary of the nation’s largest insurer, UnitedHealth Group, said in the Allen Room at Jazz at Lincoln Center.
The insurers say the moves will come in various forms. They will include bundled payments as well as aggressively negotiating contracts with doctor practices that operate “patient-centered medical homes” as well as so-called accountable care organizations (ACOs), a rapidly emerging health care delivery system that rewards doctors and hospitals for working together to improve quality and rein in costs.
Read the full story here: http://onforb.es/1c471Fi
Source: Forbes
Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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