Screening For Anxiety, Depression Cut Number Of Orthopedic Procedures Nearly In Half For One Doctor’s Practice
But the problem is that value-based purchasing hasn't caught on in the behavioral health sector at nearly the same level as other medical specialties. Media outlets report on other cost and quality issues, such as paying for emergency room visits and a fight over dialysis.
Modern Healthcare:
Missing The Whole Story: Behavioral Health Slow To Adopt New Pay Models
Value-based purchasing hasn't caught on in the behavioral health sector at nearly the same level as other medical specialties. That's partly due to the fact that most providers don't use standardized metrics to gauge outcomes and some small providers are reluctant to adopt expensive electronic health record platforms and other technology necessary to facilitate data collection and sharing. To be sure, a wealth of pilot programs are actively testing behavioral health value-based purchasing among commercial and government payers in several states. But so far, they're happening in silos. (Bannow, 5/26)
Modern Healthcare:
Getting The Price Right: Hospitals Target Variation In Joint Replacement
When HonorHealth leaders were looking for ways last year to decrease spending, the joint-replacement service line stuck out as a big opportunity. The procedures are one of the Scotts-dale, Ariz.-based system's most popular—and lucrative—service lines and make up a significant percentage of supply chain costs, which account for nearly 40% of its $1.7 billion in revenue, according to 2016 financial data from Ernst & Young. But HonorHealth was paying more for parts than its competitors. (Castellucci, 5/26)
The Star Tribune:
UnitedHealthcare Partners With Lab Companies
Minnetonka-based UnitedHealthcare announced long-term strategic partnerships this week with two large lab testing companies to develop “value-based programs” like those the health insurer has been pushing with hospitals and clinics. With the new arrangements, New Jersey-based Quest Diagnostics will become an in-network lab for more than 48 million people enrolled in UnitedHealthcare health plans starting next year, the companies said in a news release. (Snowbeck, 5/25)
The Star Tribune:
A Health Plan With A La Carte Coverage
Tony Miller spent years pushing the idea that health plans with special accounts for covering deductibles might transform patients into savvy shoppers. Now Miller has moved on to a new idea for insurance. His latest startup is a Minneapolis-based company called Bind that is selling the concept of “on-demand” health insurance, which lets workers in employer plans buy coverage for certain ailments only if they need the services. (Snowbeck, 5/25)
Houston Chronicle:
If It’s Not An Emergency, Blue Cross Blue Shield Won’t Pay
Starting June 4, Blue Cross and Blue Shield of Texas, the state’s largest insurer, will step up its scrutiny of all out-of-network emergency room claims for patients who have health maintenance organization, or HMO, plans. If, after treatment, a company review finds patients could have reasonably gone elsewhere for care, it will pay zero. That means even insured patients could potentially be on the hook for thousands — if not tens of thousands — of dollars in medical bills if they make the wrong choice. (Deam, 5/26)
Politico Pro:
Insurers, Dialysis Firms Escalate Fight Over Charity Payments
The country’s largest insurer, UnitedHealth Group, has filed a pair of lawsuits against American Renal Associates alleging that the national dialysis chain conspired to funnel patients into private insurance plans to pump up its profits. Lawmakers in California are considering tough new restrictions against third parties such as charities that pay premiums for dialysis patients. (Demko and Colliver, 5/25)
