Four Delaware health systems form new alliance

http://www.delawareonline.com/story/news/health/2016/09/15/four-delaware-health-systems-form-new-alliance/90407280/

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The new eBrightHealth is a partnership of Christiana Care Health System, Bayhealth Medical Center, Beebe Healthcare and Nanticoke Health Services

EBrightHealth dovetails with the health care reform the state is undertaking with the Delaware Center for Health Innovation, officials say. It also builds on the relationships the systems have established over the last year as they participate in the statewide Quality Partners Accountable Care Organization.

The ACO focuses on creating more comprehensive care and cost-savings for Medicare patients. As Nevin said, it’s designed to reward hospitals for disrupting their business model by encouraging them to find ways to keep people healthier so they don’t need emergency rooms or hospital admission.

Christiana Care’s Care Link program is an example of what has come out of the ACO. Carelink identifies complex patients who are high-risk, for example those who do not have access to primary care, and connects them to physicians who will reach out and find out what their needs are.

Social workers, pharmacists, behavioral health therapists and nurses are all involved.

EBrightHealth is modeled after initiatives such as AllSpire Health Partners, which is a consortium of seven New Jersey and Pennsylvania hospital systems. That organization is three years old.

Cost Control Efforts Working ‘So Far’ in MA

http://www.healthleadersmedia.com/quality/cost-control-efforts-working-so-far-ma?spMailingID=9530189&spUserID=MTMyMzQyMDQxMTkyS0&spJobID=1001355843&spReportId=MTAwMTM1NTg0MwS2#

Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won't tolerate any more cost shifting.

Health policy veteran Stuart Altman, PhD, is hopeful, but not optimistic, about healthcare delivery reforms and thinks hospitals will be forced to bring costs down because patients won’t tolerate any more cost shifting.

health care expenditures 2013-2015

Each year, we put together a cost trend report that outlines what forces are at play in the state in terms of raising spending and we have hearings every October. We are trying to play an interesting role which is not be regulatory, but really to be in the face of the healthcare system in terms of saying, “Hey  be careful. Don’t go the extra mile on in spending or pricing.”

We want to do it in a way that doesn’t destroy or even hurt the health system.  In any attempt to do that, some of the forces within the health industry scream.

But, for the most part, the hospitals have been supportive of our efforts. If we were to squeeze too hard, they would react more negatively. Everyone is engaged in a very interesting balancing act. We are trying getting the system to work more efficiently… and they are trying to control costs without destroying themselves. So far it’s working.

CBO: Hospitals’ future finances depend on increasing productivity

http://www.healthcaredive.com/news/cbo-hospitals-future-finances-depend-on-increasing-productivity/426036/

  • A new analysis from the Congressional Budget Office (CBO) has recognized that changes in laws and regulations, prompted primarily by the ACA–notablyreduced Medicare payment updates and expanded insurance coverage–can be expected to significantly impact hospitals’ future finances.
  • To help provide a sense of the impacts, the CBO’s working paper predicted hospitals’ profit margins, and the share of hospitals that could lose money in 2025 under several different scenarios.
  • The researchers noted that they provided a wide range of estimates due to “substantial uncertainty” around the predictions and how hospitals will respond to the pressures of the federal healthcare law.

Aetna faces probe over ‘politically motivated’ Obamacare exit

http://www.healthcaredive.com/news/aetna-faces-probe-over-politically-motivated-obamacare-exit/426035/

  • A group of senators is seeking answers from Aetna about its abrupt decision to leave the ACA marketplaces following the DOJ’s challenge to the company’s proposed $37 billion merger with Humana.
  • The letter came Thursday from Senators Elizabeth Warren (D-Mass.), Bernie Sanders (I-Vt.), Edward J. Markey (D-Mass.), Sherrod Brown (D-Ohio), and Bill Nelson (D-Fla.).
  • While other insurers have also scaled back their ACA participation, the probe into Aetna comes in response to a letter from Aetna CEO Mark Bertolini in which the company is perceived to have directly threatened the government that it would leave the exchanges if the merger was not approved.