Payers and providers must lay the foundation of collaboration to create an integrated healthcare system that coordinates care, lowers costs and boosts quality, according to the chief executive of Blue Cross Blue Shield of Rhode Island.
"To take waste out of the system and eliminate unnecessary spending, all caregivers and the insurers have to be aligned and committed to making hard changes," BCBSRI CEO Peter Andruskiewicz said in an interview with Providence Business News. "These changes will be good for quality of care and for costs."
Andruskiewicz cited his vision for an integrated system of caregivers who put a strong focus on prevention, population health, and keeping people healthy along with their commitment to treating and managing diseases.
BCBSRI and other insurers can play a key part in motivating providers to change their operations, according to Andruskiewicz, by rewarding doctors and hospitals based on improved patient outcomes, quality, safety and costs. To reduce costs and unnecessary spending, he said all the industry players, including hospitals, physicians, insurers, and state and federal officials, must work together with aligned goals.
"Ultimately, we are all pushing toward physician-led, patient-centric systems of care that can also lower costs," he told the Providence Business News. "We need to do this work with a greater sense of urgency."
That's why, for example, the Rhode Island insurer agreed to a five-year plan in which BCBSRI will pay Care New England, one of the state's major hospital groups, more when it meets certain quality measures, FierceHealthPayer previously reported.
A related agreement with Care New England announced last month already is improving communication and proactively addressing senior health issues, Andruskiewicz said.
Aetna also has recognized the need for strong payer-provider relationships. To foster trust between the two parties, Aetna has created joint operating committees with physicians as well as a good governance structure for each of its accountable care organizations.
To learn more:
- read the Providence Business News article