Payment reform keeps payers competitive, drives quality

Payment reform likely will continue regardless of the U.S. Supreme Court's decision on the constitutionality of the reform law. So if payers want to remain competitive, they must adjust their payment strategies going forward.

Patient-centered medical homes and accountable care organizations are only two examples of how payers are reforming their payment systems.

In a session on Thursday, "Is a Payment Model Enough? Critical Tenants of Effective Delivery System Transformation," Robert McLaughlin of Cigna and Scott Sarran of Blue Cross Blue Shield of Illinois will discuss lessons learned from their organizations' experience with these models. They also will address how payers can change provider practices, consumers' role in new payment models and the value of an embedded nurse.

Also on Thursday, Institute attendees can hear two McKesson experts, Vice President and Medical Director David Nace and Vice President, Payment Management and Analytics Jim Evans, reveal some practical advice to successfully implement value-based reimbursement. They'll concentrate on how payers can best design a value-based reimbursement program, attain provider buy-in and leverage technology.

Curious about the multiple payment reform-related challenges confronting your organization? Check out Thursday's session with Brian Day, Highmark's director of advanced analytics, and Amanda Purvis, Coventry's vice president of service operations support, talking about how the market's current challenges can power payers toward future performance and improved care. They will address how insurers are improving quality measurement, partnering with providers to drive quality and implementing risk adjustment and identification.

On the docket for Friday is the session, "Multi-payer Approaches: Creating Common Goals for Stakeholders," where execs from Anthem Blue Cross Blue Shield, Blue Care Network and HealthPartners will cover how payers can join forces to create sustainable results. They will flesh out how payers can align their goals, find common ground and discover the natural aggregators of information.

And folks from Milliman will break down the differences between the current payment reform efforts and past attempts in the Friday session, "Health Care Coverage Remodeled: Why This Time is Different." They will tackle how new technology, information, methods and attitudes could help the industry propel payment reform to fruition.

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