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Employer adoption of value-based health plan designs, which encourage workers to go to quality doctors and hospitals and work to limit overuse of medical services, is slowly taking hold.
The National Business Group on Health’s annual examination of employer health benefit packages shows value-based designs haven’t “grown much since 2016 , but nearly half of employers have incorporated some type in their benefit plan.” The designs include offers to lower worker premiums and reduce out-of-pocket costs if they “take steps to manage chronic conditions, obtain higher-quality care or more efficient care,” the group’s analysis showed.
“It’s not happening at a fast enough pace,” Brian Marcotte, National Business Group on Health's CEO, said in an interview of the move to value-based care. “It’s hard to get out of fee-for-service [medicine].”
Employers are slowly moving to value-based health benefit designs for their workers, according to... [+]
Traditional fee-for-service medicine is shown to lead to overuse of healthcare services when doctors and hospitals order up unnecessary or unneeded tests and procedures. That’s why insurance companies and the Centers for Medicare & Medicaid Services under the Obama administration are escalating the move away from fee-for-service to value-based or alternative reimbursement models that encourage more aggressive outreach to patients and management of their conditions before they get sick.
By 2018, half of all payments made to doctors and hospitals from the Medicare health insurance for the elderly will be via “alternative models.” Medicare is increasingly moving to alternative payment models like bundled payments, patient-centered medical homes and accountable care organizations (ACOs), a rapidly emerging care delivery system that rewards doctors and hospitals for working together to improve quality and rein in costs. In these models, doctors and hospitals take on more risk that they can streamline the care, improve quality and eliminate bureaucratic inefficiencies for a pool of patients or workers at a company.
Inside Obamacare: The Fix For America’s Ailing Health Care System explores the ways the Affordable Care Act will impact your health care.
Private health insurers, too, including
But employers don’t yet see that ACOs are ready for prime time. Just 24% of employers will be “actively promoting ACOs within their workforce,” National Business Group on Health survey showed.
The survey, which was conducted between May and June of this year, draws responses from 133 large employers that offer coverage to more than 15 million workers and their dependents. The National Business Group on Health includes as its members some of the nation’s largest employers, including American Express, Boeing, JPMorgan Chase and Pfizer.
