Primary Care Clinics Set to Collaborate with Premera in Shared Risk Contracts
The night before our event, we host a VIP dinner with sponsors, health care CEOs, and policy makers. It turns into a salon style conversation where everyone is able to share their views and ideas on solutions.
It’s a powerful experience, and one that everyone seems to enjoy. Everyone stuck around for 3 hours before leaving, after all.One of the key conversations we overheard was between Premera and some of the more prominent physician groups in the state. They were talking through moving to a shared-savings medical home model, and that “it’s really time that we move forward on this.”
While that conversation was off the record (which is why you’ve not heard it from me until now), I asked Premera to offer a comment about the status of the contract discussions. While things aren’t finalized yet, this was the statement released by Premera as a result.
Premera has been engaged in discussions to explore possible medical home programs with several organizations in Alaska. We’re encouraged by growing enthusiasm for the medical home concept of enhanced primary care to improve patient health and control costs over time.
The recent State of Reform conference helped stimulate and shine a light on the need for this work, and we’re optimistic coming out of that event about the possibility of collaborating with others in the healthcare system to potentially bring such programs to fruition.
The implications of care coordination contracts in the market could be significant.
Primary care physicians are organizing themselves, with the help of Clarity Health Services, to hold themselves and other specialty care providers accountable to one another around care coordination.
Without getting into the details here, the result will likely mean that referring primary care doctors will grow to expect notes and reports on the type and level of care provided by specialists to the PCP’s patient. Specialists will grow to expect that referrals from PCPs will be complete, pre-authorized, and be ready to schedule a patient.
In other words, the infrastructure is getting built that will help empower primary care physicians to pick and choose their specialty physician partners.
And, in those cases where specialists in Alaska will be unwilling to coordinate, physicians and providers in other states may be available to step in.