HCI3 Relationships Strengthen U.S. Health Care Payment Reform Infrastructure and Process

Submitted by hci3-usr on Wednesday, January 28, 2015 - 10:24

Non-profit anticipates major milestones for U.S. payment reform efforts in 2015

NEWTOWN, CT – JAN. 29, 2015 – To expedite payment reform across the U.S., the non-profit Health Care Incentives Improvement Institute (HCI3) has partnered with key stakeholders to support the transformation to a health care system based on quality and affordability. HCI3 partners include health plans, providers and purchasers who are actively working toward payment reform implementations, and technology and consulting firms offering services to support these efforts.

Organizations working with HCI3 to implement evidence-based incentive and payment reform programs include:

• Aver
• Blue Cross and Blue Shield of North Carolina
• Cigna
• Community Health Choice
• HealthQx
• Horizon Healthcare Services, Inc.
• McKesson
• McKinsey & Co
• TriZetto
• xG Health Solutions™

“We won’t see meaningful change in how we pay for health care as a nation without the involvement of many, including health plans and other payers implementing innovative approaches to provider payment and member benefits, said Francois de Brantes, HCI3 executive director. “Stakeholders offering services to support those implementations are also critical in creating a payment ‘eco-system’ where reform efforts will succeed. This work can impact 85% of the U.S. population, whereas the Medicare initiatives that have recently been in the spotlight are geared towards only Medicare beneficiaries.”

HCI3 efforts are focused on bringing economic incentives in line with the medical profession's strong desire to improve patient health through its PROMETHEUS Payment® and Bridges to Excellence® models, and certifying commercial adaptations of its ECR Analytics® software. HCI3’s ECR Analytics is a state of the art episode of care analysis software application that helps payers and providers better understand the cost and quality of care and identify direct opportunities to increase health care value.

As reported in recent research, some of the significant barriers to fully scaling the adoption of new payment models rest in payer and provider ability to operationalize new concepts of claims payments, benefit design and care processes. HCI3’s collaboration with payers such as Horizon Healthcare Services, Inc., Blue Cross and Blue Shield of North Carolina, Cigna, and Community Health Choice is designed to rapidly share lessons learned and best practices to speed up the scope of bundled payment implementations. Its collaboration with technology companies such as Aver, HealthQx, McKesson, and TriZetto is to develop solutions that will automate the claims analytic and payment processes adapted to new payment models. And finally, its work with industry consultants and care redesign services firms such as KPMG, McKinsey & Co and xG Health Solutions™ is designed to support those organizations’ efforts in accelerating payment and delivery system reform.

“Through the use of ECR Analytics, we continue to evolve our collaborative care efforts to bring value to clients, customers, and health care professionals in pursuing improved outcomes, greater customer satisfaction and cost efficiencies,” said Lynn Garbee, operations senior director, Cigna. “The application of PROMETHEUS and ECR Analytics allows our organization to take a more comprehensive view of episodes of care and to create an environment that fosters engagement across the entire care continuum. The use of such payment models will not only support meeting the needs of our partners, but will allow Cigna to advance payment reform in a rapidly evolving health care environment.”

About Health Care Incentives Improvement Institute™, Inc.
The Health Care Incentives Improvement Institute, Inc. (HCI3) is a not-for-profit organization dedicated to improving the quality and affordability of health care through evidence-based incentive and payment reform programs. It is the umbrella organization for Bridges to Excellence® and PROMETHEUS Payment®, as well the creator of Evidence-informed Case Rates (ECRs) (episode of care definitions) and ECR Analytics®. With these programs, HCI3 offers a comprehensive package of solutions for employers, health plans and providers to implement innovative solutions that can cure the incentives problems that plague the U.S. health care system

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