After celebrating Thanksgiving last week with my family, I'm still feeling grateful for many aspects of my life. As I sat down to write, I realized that I'm also thankful for many parts of the health insurance industry. I decided to dedicate this column to many of the positive changes that have happened recently--some at the hands of the Affordable Care Act and others driven by insurers themselves.
Accountable care organizations
Insurers have launched multiple types of accountable care organizations and other collaborative care models, and they're starting to demonstrate some successes. Personally, I'm grateful that payers are reaching out to providers in a more cooperative manner to improve healthcare quality and treat patients with a more holistic approach. Cigna is one of the insurers leading the attempt to form collaborative care relationships with providers based on open communication, clear standards and trust.
Given the animosity that traditionally exists between payers and providers, I applaud both sides for their willingness to work together and create new, improved relationships. Such strong payer-provider partnerships, especially ones that share critical data, can only help the industry as a whole boost quality, coordinated care.
Value-based payment (and care)
There's no doubt that the insurance industry is moving toward a value-based payment system, and for that I'm thankful. We need a healthcare industry that's based on improving quality and value to patients rather than making money. Although many doctors still operate on a fee-for-service basis, insurers are increasingly pushing for value-based arrangements.
Indeed, WellPoint has more than 110,000 contracted physicians and more than 100 ACO-type organizations, while UnitedHealth's accountable care contracts total $30 billion. Meanwhile, the Blue Cross Blue Shield Association's plans spend more than $65 million a year in value-based payment programs that saved $500 million in 2012 alone. Because of these efforts, 40 percent of insurers' reimbursements to providers are for value-based care--an increase of 29 percent from 2013.
Finally, as the insurance industry continues to transform in a post-ACA market, payers are looking to focus more on their members' experiences than ever before. That includes strengthening member relationships and fostering high levels of satisfaction, gaining members' trust and easing members' concerns. It also means more innovation--like the kind coming out of upstart, for-profit Oscar Insurance Corp., which created a completely new kind of online presence that's easy and transparent for consumers.
I'm grateful that insurers place a higher priority on their members' satisfaction and well-being. - Dina (@HealthPayer)