Becker’s Hospital Review reports on a June 2014 Accountable Care Organization update by Leavitt Partners. According to that update, Leavitt Partners has tracked 626 ACO’s across the U.S. 329 have government contracts; 210 have commercial contracts, and 74 have both. The total number of ACO covered lives is now over 20 million.
Every single health plan has some type of reward and incentive program. I would argue that if a health plan doesn’t have a significant health and wellness incentive program sometime during the year 2015, they won’t be able to compete. When somebody goes to buy health insurance on a state exchange, for example, it will be very hard for a health plan to win business if they don’t have a robust reward program.
It’s going to start to look just like your credit card, airline, and hotel loyalty programs. It’s really grown and evolved. The thing about incentives is that you don’t write the check until somebody does what you want them to do. So, as long as you align it to the right behaviors, it’s got almost a built-in return.
Health Data Management reports about the increasing success of CAQH’s EFT and ERA enrollment program that allows providers to enroll in electronic payments with multiple payers at no cost, eliminating redundant paper forms and saving administrative time and costs.
Aetna and Cigna were the original participating insurers during 2013. In January, HIPAA operating rules requiring payers to support EFT and ERA went into effect and multiple insurers have joined during the first six months of 2014. They include WellPoint and 14 affiliates: Unicare, Empire Blue Cross Blue Shield, and Anthem plans in Colorado, Connecticut, Indiana, Kentucky, Maine, Nevada, New Hampshire, Ohio, Virginia, California, Missouri and Wisconsin. Additional insurers now participating include Blue Cross Blue Shield of Georgia, BlueCross BlueShield of Tennessee, CDPHP, CareCentrix, MAPFRE and Midwest Health Plan. Other payers committed to join in coming months are Kaiser Permanente, Humana, Health Plan of San Mateo and First Community Health Plan.