The Pennsylvania Department of Health wants insurance companies to pay doctors and hospitals based on how effectively they treat patients, not solely on how much care they supply, said Secretary of Health Karen Murphy.
To help make that happen, the department will survey insurers statewide to see how that “value-based” approach is catching on, Ms. Murphy told employers Thursday at a health conference held at the Pittsburgh Marriott City Center, Uptown. The annual symposium is put on by the Pittsburgh Business Group on Health, a nonprofit coalition.
“We would like to spread the innovation across the state and not just have pockets,” she said.
Ms. Murphy isn’t sure how soon the health department might conduct its insurer survey, but said the results will help set statewide goals for expanding value-based health care payments. Traditional health coverage typically centers on paying providers for how often they care for patients.
The federal Affordable Care Act passed in 2010 has begun pushing the health care sector toward more value-based compensation. For instance, the law lets Medicare cut hospitals’ reimbursement payments when their readmission rates miss federal targets.
Making health care more efficient also requires better communication among providers and a better understanding of patients, said Barry Bittman, the chief population officer at North Side-based Allegheny Health Network. He said 20 percent of a health system’s patients can account for about 80 percent of the service it provides.
“When we can develop a deep relationship with the people we’re privileged to care for, in a non-threatening way — that’s when the magic happens,” Dr. Bittman said at the symposium.
Employers can help strengthen care by crafting informed strategies for workers’ insurance coverage, said Mike Parkinson, a senior medical director at Downtown-based UPMC Health Plan. He cited estimates suggesting as much as 40 percent of health care spending may be waste.
Those figures may be especially high in Pennsylvania, where Ms. Murphy said elevated rates of doctor visits and other medical attention belie lackluster public health trends. She encouraged employers to look at value-based insurance concepts, which she said should lead to better health.
“To sum it up, we’re spending more and producing far less outcomes than we should be,” she said.
Source: Pittsburgh Post-Gazette