In the News: Feb 7–14

Cigna Reimbursements Paid to Value-Based Models

Cigna recently announced that more than half of its Medicare and commercial health care provider payments are from alternative payment arrangements in the company’s top 40 markets. UnitedHealth Group and Aetna, 2 of Cigna’s largest competitors, previously stated that over half of their reimbursements are from value-based care (VBC) models. Cigna also reported that the shift from fee-for-service payments saved over $600 million between 2013 and 2017. Following its recent merger with Express Scripts, Cigna is now looking to expand its value-based model to pharmaceutical reimbursements. Some at Cigna believe the Trump administration’s recent proposal for new Medicare drug plan regulations will provide an opportunity for payers to further develop value-based care models with drug manufacturers.

With the shift to value-based care, health care providers are transforming their strategy to adapt to the changing landscape, which can be especially challenging for academic medical centers (AMCs). To learn more about AMC-specific challenges in VBC and how some institutions are building their VBC portfolio to drive growth and success, please join us for our upcoming webinar AMC Approach to Value-Based Care on Wednesday, April 3, 2019, hosted by Sg2 experts Tawnya Bosko and Michael Humphrey.

Aetna/Apple Partnership Incentivizes Healthy Living

Aetna, part of CVS Health, recently partnered with Apple to provide customers with a health application known as Attain. Attain uses an Apple Watch to track daily activities and offer personalized health goals, and it provides incentives for making health conscious decisions. All app recommendations and functions are based on clinical guidelines and can include notifications such as vaccination reminders or lower-cost options for lab tests. Rewards can be used to purchase gift cards or assist in the payment of the individual’s Apple Watch. Initially, the application will be available to 250,000 to 300,000 Aetna commercial members on a first-come, first-served basis.

Attain represents just 1 of thousands of mobile health applications. At Sg2, we believe it is crucial to understand how these technologies will soon drive benefits for both patients and providers. The Sg2 Expert Insight Is Health Care Ready for the Digital Health Tsunami? highlights the major trends in digital health and outlines the overall landscape for your organization.

California Workforce Shortage Prompts $3 Billion Plan

The Los Angeles Times recently published an article about California’s $3 billion plan to address health care provider shortages throughout the state. While over 33% of California’s doctors and nurse practitioners are approaching retirement age, the state is already anticipating a need for 4,100 more physicians and 600,000 additional home care workers over the next decade.

Several proposed solutions to this impending shortage are currently under consideration, including extending Medi-Cal coverage to legal US young adults, increasing health care subsidies for middle-class families, implementing more incentives to join the health care workforce such as through student loan forgiveness and scholarships, and expanding California residency opportunities. The most controversial proposed solution, however, is to grant nurse practitioners the ability to work independently from physicians. California, alongside 27 other states, still requires nurse practitioners to work under a doctor’s supervision.

Patients in California are not only experiencing long wait times at doctors’ offices, but they are also traveling long distances to see specialists and to work with their preferred provider. By leveraging care-team maximizers and channel optimizers, health care organizations can help mitigate workforce shortages and increase the much needed access for its patients. To learn more about potential solutions to workforce shortages, please see Sg2’s Workforce Planning infographic.

  • Share
  • Follow Sg2 on Twitter
  • Connect with Sg2 on LinkedIn

Tags: , , , , , , , ,