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Planning for a “Shared Accountability” health plan product

Planning for a “Shared Accountability” health plan product

blog post 5

In 2011, Intermountain Healthcare set a significant commitment to lower the projected increase in healthcare costs by 2016. We are currently on track to meet that objective — saving the community hundreds of millions of dollars. At the same time, we continue to improve clinical outcomes and quality of care.

Intermountain and SelectHealth will launch a commercial health plan product in 2016 based on “Shared Accountability” principles. That means that everyone involved—hospitals, physicians, patients, and employers—will share accountability in choices that affect participants’ health and healthcare choices. Intermountain and SelectHealth will keep average annual premium rate increases on this product close to the general inflation rate. That will be a significant cost savings for all involved.

More details about the “Shared Accountability” health plan product:

The official name of the product is still to be determined. We’re tentatively referring to it as the “Shared Accountability” product, because the plan is based on Shared Accountability concepts.

SelectHealth has expertise with other similar plans. Currently, SelectHealth offers two fee-for-value plans based on accountable care principles: SelectHealth Advantage (a Medicare Advantage plan) and SelectHealth Community Care (a Utah Medicaid Accountable Care plan). SelectHealth will be the first payer to offer Intermountain’s Shared Accountability approach to the commercial market, offering it to fully insured large employers that are purchasing health plans for their employees.

The Shared Accountability product will be informed by a Physician Payment Model beta test. Intermountain launched the test in the fall of 2013. The beta includes a small number of patients served by 383 physicians at 15 clinics. Both primary care and specialist physicians are participating. Tools developed for the model give physicians access to information that supports care decisions. Clinicians can see current performance and feedback on service, quality, and total-cost-of-care goals. They can also see overall health measures for the group of patients, patient risk scores, and variances in how care is provided. With input from participating physicians, we continue to evaluate and refine these tools as we consider expanding their use.

SelectHealth is designing benefits to engage plan members — and support physicians. The plan benefit design will encourage and reward members for being more engaged in their personal health and wellness and more involved in their personal healthcare decisions.

This model is significantly different from traditional fee-for-service models that pay based on volumes of covered services provided. We anticipate other payers will be developing similar products. In fact, according to a report at a recent Leavitt Partners conference, more than 600 “fee-for-value” networks are already being developed nationwide.