Regional partnership formed to lower medical bills [The Morning Call (Allentown, Pa.)]
By Tim Darragh, The Morning Call (Allentown, Pa.) | |
McClatchy-Tribune Information Services |
Valley Preferred, a managed care organization aligned with
About 5,500 local patients stand to benefit from
"Valley Preferred is pleased to partner with
At its heart, the accountable care model strives to put the brakes on medical costs while improving patients' health. It does this by giving doctors and their staffs incentives to keep people healthy and addressing their health conditions before they become more serious or chronic ailments.
Once the patient needs care, the emphasis is on providing appropriate care and following up afterward to ensure the patient has a positive outcome.
The goal is to move from fee-for-service health care, which in
According to the local
The initiative is based on the "patient-centered medical home," which is not a place but a way of caring for individuals that is based on primary care and the individual's needs through a coordinated team of providers, the organizations said.
Key to the success of the initiative will be care coordinators -- nurses in the Valley Preferred providers' offices.
"We're really trying to make sure we close care gaps," said
That sort of proactive approach to care should be especially beneficial to those with chronic conditions such as heart disease and diabetes, because proper management of them can stave off much more costly and debilitating conditions.
At the same time, everyone benefits if healthy individuals stay that way, she said. "If I'm your doctor, ... I want to keep you from getting diabetes and high blood pressure," Lewis said.
Unlike other attempts to rein in health care spending, the Cigna-Valley Preferred initiative is not about finding ways to deny care, said Dr.
"We don't want to lower costs by cutting fees or not providing care, which is the wrong way to go," she said.
At the end of a year,
Additionally, some of the savings will be applied to underwriting lower premiums for the next year, Stasiuk said.
"We need a patient-centered health care system that emphasizes prevention and primary care, and rewards physicians for quality of care and outcomes," said
Accountable care initiatives are growing across the country.
As a preferred provider organization, Valley Preferred links more than 4,100 doctors and 18 hospitals across the region with 18 insurance companies.
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