Health care is expensive in the Nutmeg State. The reasons are plentiful, but a more informed and better coordinated utilization of our current system could help to lower health care costs while improving outcomes and making it more affordable for everyone. Access to quality, affordable health care is attainable and is being modeled in an industry collaboration currently underway in our state.
ConnectiCare and Saint Francis Healthcare Partners began taking a closer look at the payer-provider relationship a couple of years ago. We quickly identified some significant (and frustrating) challenges for consumers under our current fee-for-service health care model. The process can be confusing, uncoordinated, and often leads to duplicative or unnecessary procedures with lower quality outcomes and higher costs.
We saw a window of opportunity to test a better approach to the way payers work with providers; one that is collaborative, reduces inefficiencies and duplication of activities, shifts the focus to the value of care, and overall enhances the patient experience.
Along with ConnectiCare, Saint Francis Healthcare Partners and other industry participants, The Connecticut Health Council recently formed the Value Based Relationships work group. The group consists of health plan representatives and provider systems, doctors, pharmaceutical companies, consumer advocates, insurance brokers, various social services providers and others. Working together and leveraging our collective expertise, we can establish integrated models of care based on comprehensive metrics and quality outcomes, rather than to continue to rely on the inefficient, disintegrated fee per health care transaction model.
Our goal is to allow the health care consumer to pay for the quality of outcomes rather than the number of individual services a system provides them. Our pilot project is currently focusing on Type 2 Diabetes, and how each group member is involved with the care process for treating that disease. By beginning with this single disease focus, we are able to approach the best outcome creatively and as an integrated system rather than as individual stakeholders.
So far, we are encouraged by the level of interest and cooperation of industry partners, but we need your help. Contact Amy Cunningham at the Connecticut Health Council to join this important effort at firstname.lastname@example.org or 860-728-2298.
Also, check out our recent column in the Hartford Business Journal on the topic.