In a move that could thwart competition, health systems in Wisconsin are promising employers definite savings if they offer a health plan that requires employees and their families to go only to their facilities and doctors, reported the Milwaukee Journal Sentinel
Quality Health Solutions, a partnership involving Milwaukee-area health systems, northern Illinois health systems, the Medical College of Wisconsin and independent physicians, is embracing exclusive contracts. Similarly, Aurora Health Care is guaranteeing employers' costs will rise slower than the overall market with participation in its Aurora Accountable Care Network, the article noted.
Not only could narrow networks improve care coordination and management of chronic conditions, but they also could foster improved compliance with clinical guidelines. "This is the engine for making healthcare better," Quality Health Solutions CEO Peter Pruessing told the Journal Sentinel.
Employers increasingly are supporting the narrow "high-performance" networks and choosing to contract directly with hospitals and physicians for high-quality low-cost care, reported American Medical News.
For example, Lowe's has directly contracted with Cleveland Clinic to allow its employees and their families to be taken to the medical center for heart surgery at no out-of-pocket cost. Perdue Farms has created an entire network of primary care, specialty care and hospital care for its employees. But along with the rise in tiered and limited networks often comes confusion for patients and physicians.
For more:
- read the Journal Sentinel article
- here's the amednews article