On the heels of a coordinated care settlement with Anthem, St. Louis-based Mercy is partnering with one other well being insurer.
Per the brand new settlement, Humana’s Medicare Benefit members who’re sufferers at Mercy amenities and doctor practices will achieve in-network entry to Mercy Virtual. Staffed with greater than 300 clinicians, Mercy Digital presents 24/7 telehealth providers, together with digital major care at residence.
As well as, the settlement hyperlinks supplier reimbursement to high quality of care, shifting the fee mannequin for Mercy physicians from fee-for-service to value-based compensation.
“Mercy is dedicated to working with our communities to enhance healthcare whereas additionally decreasing the whole value of care,” stated Shannon Sock, Mercy’s government vp, chief strategist and CFO, in a information launch. “Sturdy payer relationships, like this one with Humana, will assist in our long-term journey to supply extra seamless look after our sufferers. Collectively we will make an actual distinction for sufferers, which is very vital throughout this pandemic.”
The brand new settlement brings collectively an insurer with a sizeable membership and an enormous healthcare group.
Mercy consists of greater than 40 acute care, managed and specialty hospitals, pressing care places, imaging facilities and pharmacies, in addition to 4,000 major and specialty care clinicians in Arkansas, Kansas, Missouri and Oklahoma. And, as of January, Humana’s Medicare Benefit membership totaled greater than 4.8 million.
“This settlement unites two organizations striving to supply care that’s extra accessible, customized and coordinated — a dedication that’s extra vital than ever proper now,” stated Jeremy Gaskill, Humana regional Medicare president, in a information launch.
The information of the partnership between Humana and Mercy comes just some weeks after the well being system entered into a cooperative care agreement with Anthem. That partnership features a nearer alignment between medical care and reimbursement in addition to elevated knowledge move between Mercy and Anthem.
Because the healthcare business strikes towards value-based care, provider-payer partnerships that goal to enhance care high quality have turn into extra standard.
For instance, on the finish of final yr, Salt Lake Metropolis-based Intermountain Healthcare and UnitedHealthcare established an accountable care organization with the purpose of enhancing care coordination and well being outcomes for the payer’s Medicare Benefit members. In one other occasion, Butler Hospital, a psychological well being facility, partnered with Blue Cross & Blue Protect of Rhode Island to reduce hospital readmissions.
“If both a payer or supplier is trying to fill a spot and increase optionality of providers for companions or members, these kinds of revolutionary partnerships are helpful as a result of they supply each events a chance to rapidly refine and construct versus recreating the wheel,” stated Nick Donkar, PricewaterhouseCoopers’ well being providers offers chief. “This technique permits a win-win resolution briefly order.”
Supplier-payer partnerships will probably proceed into the long run to assist each entities fill gaps as they consider enhancing care in a digital atmosphere, he stated.
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