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Harnessing IT for Payment Reform

May 18, 2011
by Jennifer Prestigiacomo
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Beacon Communities discuss strategies on how to involve payers

At yesterday’s half-day meeting “Health IT in an Era of Accountable Care: Update from the Beacon Communities,” hosted by the Engelberg Center for Health Care Reform at Brookings (Washington, D.C.) in collaboration with The Office of the National Coordinator for Health IT (ONC) payment reform was one of the topics at the forefront of the conversation.

With the Indianapolis-based WellPoint Inc., which pays 1,500 hospitals for services to 34 million of its members in 14 states, announcing its mandatory value-based purchasing program, the time has never been more prescient for continuing the conversation about getting payers involved in quality-based medicine and payments.

Sabrina Heltz, senior vice president of healthcare system quality, Blue Cross and Blue Shield of Louisiana, was disappointingly the only payer on the panel, and she noted that payers are often excluded from conversations involving patient care. BlueCross BlueShield of Louisiana provides a link to regional quality incentive programs to the Crescent City Beacon Community (CCBC), based in New Orleans that is focused on improving control of cardiovascular disease, diabetes, and asthma. Heltz said that BlueCross’s Quality Blue program rewards physicians for quality outcomes and is based on the Bridges to Excellence program, a nationally recognized quality rewards initiative.

Heltz’s position was that health plans should be partners with providers, and “can row the boat in the same direction” to help incentivize quality outcomes. She noted that if health plans knew about Beacon Community projects, they could leverage those initiatives along with their own programs.

Catherine Bruno, vice president and CIO, Eastern Maine Healthcare Systems, and executive sponsor for the Bangor Beacon Community noted that Bangor had chosen to engage large employers before bringing in insurers.

All in the room agreed that providing complete data to providers and payers on how well quality improvement programs are working is key to the process, yet very challenging. Greg Pawlson, M.D., M.P.H., executive vice president of National Committee for Quality Assurance, said that some studies show that even advanced IT systems can’t extract this kind of data. Bruno said her community’s strategy was getting stakeholders to practice sharing data and setting out 90-day improvement plans. After the three months, the team come together to clean and normalize the data, agree on definitions, and work on specific performance improvement measures.

What do you think is the best way to engage payers in quality improvement programs? Leave a comment below.

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