Success in Commercial Quality-Based Payments
Systematic collaboration between payers and providers is the key to unlocking improved care delivery and lowering the total cost of care. Integrated relationships between payers and providers are being driven by reimbursement models such as the rise of accountable care and bundled payments. Value-based care is here, and payers and providers are dynamically changing their operations to collaborate to improve patient outcomes and reduce the cost of care. Ochsner Health Network’s (OHN) recent report around quality-based payments continues to validate and support this.
OHN, a leader in healthcare delivery innovation, and the most advanced Clinically Integrated Network in the nation, has recently reported over $34 million in shared savings and $5.5 million in quality payments from its value-based agreements with two of Louisiana’s largest commercial health insurers.
The organization achieved its largest shared savings to date in recognition of the significant improvements in patient outcomes and quality care measures its physicians delivered in 2017-2018.
Revenue from shared savings and quality payments is used to invest in infrastructure and to reward physician practices for their additional focus on keeping patients healthy and providing efficient, high-value care.
OHN providers reduced the total cost of care for its patient populations by:
- Emphasizing preventive care
- Improving the control of chronic conditions
- Focusing efforts on reducing avoidable emergency department visits and hospital readmissions
- Developing programs that target improved care management for its most vulnerable patients.
These results reflect the resources and efforts that OHN, and its participating physicians, have put into delivering the most effective care models, providing the highest quality of care available, pairing healthcare outcomes with significant cost savings.