Em­ploy­ers link­ing cen­ter-of-ex­cel­lence con­tracts to value-based pay

Modern Healthcare - - NEWS - By Mara Lee

Rather than solely shift­ing costs to work­ers, large em­ploy­ers are jump­ing on the value band­wagon in or­der to cur­tail health­care spend­ing.

For in­stance, 47% of com­pa­nies are steer­ing pa­tients to­ward cen­ters of ex­cel­lence for ortho­pe­dic surg­eries com­pared with 40% last year, ac­cord­ing to a new sur­vey by the Na­tional Busi­ness Group on Health. Over­all, 88% of sur­veyed em­ploy­ers ex­pect to use cen­ters of ex­cel­lence for transplants, or­tho­pe­dics and other pro­ce­dures in 2018.

Providers should an­tic­i­pate that 21% to 48% of those con­tracts will be bun­dled pay­ments or an­other al­ter­na­tive pay­ment model.

Two-thirds of large em­ploy­ers are of­fer­ing work­ers sec­ond-opinion de­ci­sion sup­port or as­sis­tance from nav­i­ga­tors on how to stay in their provider net­work, ac­cord­ing to the sur­vey. Also, 64% of­fer claims dis­pute as­sis­tance.

At the same time, em­ploy­ers ap­pear to be less en­thralled with carv­ing out nar­row net­works, with 26% of large em­ploy­ers sur­veyed say­ing they use them now and only 19% pre­dict­ing they will be do­ing so in 2018. The re­port added: “If the health­care cost trend be­gins to in­crease again, this may be one of the first ar­eas em­ploy­ers go to rein in costs.”

The sur­vey re­flects 2018 ben­e­fits plan­ning for 418 em­ploy­ers cov­er­ing 15 mil­lion lives.

On av­er­age, these em­ploy­ers will spend about $14,150 a year for each em­ployee’s in­surance plan, which cov­ers an av­er­age of 2.1 peo­ple. That spend­ing is an in­crease of 5% from 2017 and rep­re­sents the fifth straight year of 5% in­creases.

The in­creases are slightly be­low the fore­cast ag­gre­gate med­i­cal spend­ing in­crease, which is ex­pected to be 6.6% next year. Na­tional Busi­ness Group on Health Pres­i­dent and CEO Brian Mar­cotte said health in­fla­tion con­tin­ues to rise twice as fast as pay in­creases and three times as fast as gen­eral in­fla­tion, and that’s not sus­tain­able in the long term.

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