News | May 13, 2015

Major Market Movement Toward Alternative Payment Models Spurring Provider Partnerships With Premier

Providers developing clinically integrated networks and implementing population health management strategies better positioned to succeed under future reforms

Premier, population health management, alternative payment

May 13, 2015 — Pressure to create alternative payment models has led to a significant increase in provider interest in partnering with Premier Inc. to develop and implement population health management strategies.

The following providers signed population health advisory services agreements with Premier this calendar year to develop clinically integrated networks, and implement Medicare shared savings and state-based Medicaid payment models:

  • Ellis Medicine of Schenectady, New York, a 423-bed community and teaching healthcare system with four campuses serving New York's Capital Region;
  • Innovative Health Alliance of New York (IHANY) LLC, which is the first accountable care organization (ACO) in Albany and a partnership between Ellis Medicine and St. Peter's Health Partners, two of the region's largest health systems;
  • LifeBridge Health of Baltimore, which includes three hospitals and several other related subsidiaries and affiliates;
  • North Shore-LIJ Health System of New York, a health system with 19 hospitals, more than 400 outpatient physician practices, 12,000+ affiliated physicians, and a vast network of skill-nursing, rehabilitation, home care, hospice and other services; and
  • Summit Healthcare Regional Medical Center of Show Low, Arizona, a private, not-for-profit organization with 89 licensed beds.

 

"The Affordable Care Act and the recently enacted sustainable growth rate (SGR) replacement legislation are increasingly pushing providers away from fee-for-service and toward alternative payment models, such as ACOs and episodic bundled payment programs. Given the pace of change, these models are rapidly becoming the new normal," said Wes Champion, senior vice president of Premier Performance Partners.

In 2014, KLAS ranked Premier as having the best overall performance in providing advisory services to support ACO initiatives.

A key element to developing alternative payment models is clinical integration across the healthcare continuum, including physicians, hospitals, post-acute and home health providers. A clinically integrated network is one of the first steps in aligning physicians, health systems and payers to collectively and financially commit to improving the quality and efficiency of care delivered to the population it serves.

"Our clinically integrated network will help to improve care coordination, communication across providers and the ability to share savings, as well as align incentives around making improvements in population health and achieving the triple aim," said James K. Reed, M.D., president and CEO of St. Peter's Health Partners, and board member of IHANY. "Premier is a key partner in helping us create the network structure necessary to integrate medical staff and support our Medicare Shared Savings Program (MSSP) ACO in partnership with Ellis Medicine."

In addition, Premier is supporting several New York hospitals as they develop and implement alternative payment models as part of the state's Delivery System Reform Incentive Payment (DSRIP) program. DSRIP is a New York state Medicaid program that was formed to restructure the healthcare delivery system through investments in population health management infrastructure and performance-based payments, with the primary goal of reducing avoidable hospital use by 25 percent over five years.

Premier also partners with the Greater New York Hospital Association (GNYHA) and its subsidiary Nexera Inc., to support enhanced services to their member hospitals as they navigate the transition from volume-based to value-based payment models advanced by DSRIP and other initiatives.

Premier provides population health data management analytics, benchmarking services and dedicated experts to support the development of alternative payment model capabilities and implementation.

For more information: www.premierinc.com

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