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Providers Offering Price Guarantees to Insurers to Stabilize Employer Health Costs

From the National Business Coalition on Health: According to Forbes, one of the Midwest’s largest providers of medical care is bringing a price guarantee to a new concept being pushed by the Obama administration that rewards doctors and hospitals for working together to improve quality and cost.

Milwaukee-based Aurora HealthCare has formed an Accountable Care Organization (ACO) that is working with Aetna Inc. and Wellpoint subsidiary Anthem Blue Cross and Blue Shield in Wisconsin packaging commercial health insurance products using Aurora doctors and hospitals that offer small and mid-sized businesses a “price guarantee".

The concept relies on the cost savings an ACO is expected to achieve through greater care coordination and care management. If the providers in the ACO achieve cost savings through improved care, they share money saved with the health plans. Aurora executives say they can promise the stable rates in what employers spend on health care “as a result of improved patient outcomes and efficiencies.”

Read Hospitals as Employers Using Wellness Programs Find Benefits Beyond a Healthy Workforce to see how hospitals are learning to manage the cost and quality of care through their own employee benefit and wellness programs.

Aurora’s commitment is that the employer’s costs won’t go up by a certain amount for three years. To get the guarantee, the employer has to sign a three-year contract with either Aetna or Anthem. Costs savings will vary depending on the employer’s past cost increases and “claims experience,” but rates could potentially drop 10 percent, Aurora says.


Posted by Cristie Travis at 8:47 AM

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