Hub and Spoke ACOs May be Hard Sell In U.S.

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. Continue reading

Highmark Expands Closed Network Plans to West Virginia, Delaware

Highmark Health Services on Friday announced it is expanding its closed network product into West Virginia and Delaware in January. Private exchanges, also called defined contribution health insurance plans, allow employers to offer employees a variety of Highmark products within a fixed budget.

Highmark’s private exchange, called MyBenefits, started in 2011. As of July, nearly 80 businesses were using the product, with nearly 6,000 members enrolled, according to the company.

Read the full story at bizjournals.com

 

Top November Posts on the Health Plan Innovation Blog

For the month of November the Top Three posts on the Health Plan Innovation Blog were:

1. Highmark Issues Health Gift Card

2. Yes, we are expensive, but we do poor work

3. Humana Website is a Wiki for Health Care

Continued comments on these and any other posts are always welcome. To receive immediately updated headlines from the Health Innovation Blog, you can grab the blog RSS feed for your reader, or you may syndicate the feed on your Web site.

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