As Obamacare Looms, Insurers Look Beyond Fee-For-Service Medicine, Say Execs At Forbes Healthcare Summit 2013

Bruce Japsen, Contributor

“I write about health care and policies from the president’s hometown”

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 +0.12%(UNH), Humana HUM +0.02% (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.

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.

ACOs began contracting with the Medicare program last year under an initiative that is part of the Affordable Care Act and now most private insurers like UnitedHealth,  Aetna AET -0.58% (AET), Humana,Cigna CI +0.72% (CI) and most Blue Cross plans are linking with ACOs to care for more patients.

Bruce Broussard, president and chief executive officer at Humana said about 30 percent of its health plan members are being treated by medical-care providers that are contracting with the insurer under “value-based” contracts rather than fee-for-service.

At UnitedHealth, meanwhile, the insurer is working to more than double from $25 billion to $50 billion annually, the value of contracts it has with doctors and hospitals based on quality and cost efficiency measures.

see how major insurer’s are changing their strategies to adjust to upcoming challenges. 

About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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