Healthways Puts Focus on Providers
The agreement will cover the entire continuum of care from pre-acute to inpatient to post acute care.
THR will quickly rollout some programs such as hospital readmission management. In terms of population management it's meeting with health plans to get a handle on their attributable lives in the THR physician group to develop an ACO-like gain sharing arrangement with the individual health plans, such as Aetna and UnitedHealthcare, so they'll look to THR to manage their members.
Scholl says one advantage of THR and physicians being in the driver's seat for population management is that the program can be uniform across multiple health plans. As it stands now six different insurers can assign six different care coordinators to a physician's office. "If the health system and physicians can work together, which is our aspiration, we'll make those investments across the population."
How the success of the THR-Healthways relationship will be defined remains a question mark for now. Scholl and Farris say the two are defining the metrics now. The program will include a well being assessment developed by Healthways, HEDIS scores will be used, and the two may develop their own outcome measures for both cost and quality.
Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
- How Top-Ranked MA Plans Earn Their Stars
- Readmissions: No Quick Fix to Costly Hospital Challenge
- How Hospitals Can Become 'Upstreamists'
- 4 Ways to Lower the Cost to Collect from Self-Pay Patients
- House Calls Key to Pioneer ACO Success
- How Telehealth Pays Off for Providers, Patients
- 4 Tips for Managing Employed Physicians
- Defensive Medicine Still Prevalent Despite Tort Reform
- WellPoint Dominates Nearly Half of Markets, AMA Says
- 'Overtreatment' Debate Circles Back to Lung Cancer Screening