Health Insurance Payment Models
From Patient Determinants
These are health insurance payment models that offer incentives for healthcare systems, physicians and patients to design interventions that improve health behavior, healthcare activities and overall health of patients. They include concerted efforts such to reward healthy behaviors and discourage non healthy actions. See which Organization Interventions work.
Contents
Accountable Care Organizations
See Accountable Care Organizations Examples
Episode-Based Payments
See Episode-Based Payments Examples
Patient-Centered Medical Homes
Patient Incentives
Performance Based Pricing
- Cigna, Novartis agree on outcome-based price for heart drug (2/9/16)
- Cigna first insurer to reach value-based agreements for new class of cholesterol drugs (5/12/16)
Provider-Based Health Plans
Value-Based Care Programs
- UnitedHealthcare of Florida awards physicians $2M in bonuses tied to quality (2/27/17)
- Study says no evidence pay-for-performance improves outcomes (1/11/17)
- Blue Cross Blue Shield health plans, Cigna, and UnitedHealthcare are leading the way in alternative reimbursement structures such as bundled payment models and shared saving programs to expand their value-based care payment footprint in recent years. (1/17/17)
- Humana, Aetna, Cigna Invest in Value-Based Care Payment Models (1/6/17)
- UnitedHealth, Aetna, Anthem Near 50% Value-Based Care Spending (2/2/17)
- Doctors Earn More Than $148 Million In Quality Of Care Bonus Payments For Improving Health Outcomes, Addressing Care Opportunities For UnitedHealthcare Medicare Advantage Members (8/4/16)
- 4 strategies BCBS used to save $1B through patient-centered programs. These programs include BCBS' accountable care organizations, patient-centered medical homes, pay-for-performance programs and episode-based payment programs — emphasize prevention, wellness and coordinated care, in conjunction with reducing waste in the healthcare delivery system. (6/2/15)
Value-Based Insurance Design
Health plan benefit design to increase health care quality and decrease costs by using financial incentives to promote cost efficient health care services and consumer choices
