A post today on AISHealth.com describes a new alliance in western Pennsylvania between Highmark Health Services and six Allegheny Health Network (AHN) hospitals as being “like an ACO without walls.”
The article, which was reprinted from THE AIS REPORT ON BLUE CROSS AND BLUE SHIELD PLANS, reported that this alliance is part of Highmark’s effort to accelerate the shift from volume-based, fee-for-service (FFS) payment to a system that pays for value.
Highmark describes the alliance, in this article, as a way to foster more integrated care, moving beyond primary care physicians (PCPs) in its Patient-Centered Medical Home (PCMH) program to add specialists and hospitals to the mix.
A post also appearing today on FierceHealthcare.com examines what it will take for true payment reform in healthcare. The article written by Alicia Caramenico takes a look at a report in the Harvard Business Review that studied a “hub and spoke” approach to healthcare assets that is finding some success in India. For example, they concentrate specialists and sophisticated equipment at urban hubs. Spoke facilities surround the hubs and focus on diagnosis, routine treatment and follow-up care and send patients to the hubs for complex procedures and surgery, the article noted.
However, this system may be more difficult to construct here in the U.S. as the AIS article pointed out – in its effort to create greater teamwork among community PCPs, specialists, hospitals and health systems, Highmark acknowledges a glitch: The alliance is a tough sell to small community hospitals in outlying areas that worry the model will drive patients to Pittsburgh despite the insurer insisting that the aim is to keep care local.
Read AIS article
Read FierceHealthcare article
Read Harvard Business Review article