Partnership with Signify Health will improve health outcomes for more than 220,000 state health plan members with comprehensive “episode of care” pricing
The Connecticut Office of the State Comptroller is partnering with Signify Health to improve health outcomes for certain common procedures and save on costs through a new “Network of Distinction” program. The doctors, hospitals and provider groups in the network will provide improved patient outcomes at a competitive fixed price for care from evaluation to recovery.
This innovative “episode of care” delivery and payment model sets a new industry standard by aligning clinical and financial incentives for the state employee health plan and the Connecticut Partnership Plan, totaling more than 220,000 members. Under the initial agreement, 118 health care provider groups have committed to meet a set of quality care standards at the lowest possible cost. New groups will continue to be added throughout the year.
“By prioritizing the highest-quality care and aggressively negotiating comprehensive pricing, we can achieve the dual goals of lowering overall health costs and achieving better outcomes,” said Comptroller Kevin Lembo. “Everyone deserves access to dependable health care and, by leveraging the market power of the state health plan, it’s my hope that we can start shifting the dynamic statewide to more patient-centered, preventive care.”
The Network of Distinction program significantly reduces variations in costs by setting fixed prices for certain health events that may be delivered by multiple providers across multiple sites, a model known as an “episode of care” payment. Over 20 procedures and conditions will be available at launch including knee replacement, colonoscopy, cataract surgery and care related to pregnancy. Also featured is a comprehensive spine episode aimed at helping members avoid surgery.
Signify Health is supporting the state with its set of episode of care solutions that includes identifying, contracting with and supporting all of the providers in the Network of Distinction, as well as all other providers that have agreed to fixed, guaranteed episode pricing. This allows the state to improve patient outcomes and secure significant savings by contracting with a large portion of the network and the highest-quality options.
“We are proud to be working alongside the State of Connecticut to offer higher-quality and more cost-effective care that will drive better health and social outcomes for people living across the state,” said Kyle Armbrester, CEO of Signify Health. “Episode-based payment models have been proven in the Medicare space. Now, Connecticut is showing how effective they can be in the employer space. This represents a first for the nation in the breadth of conditions and procedures that will be managed collaboratively by network providers and sets a new benchmark for value-based care in the country.”
Creating accountability for episode-of-care outcomes better aligns the incentives for providers and patients. The hospitals, health systems and physician groups selected into the Network of Distinction all have low rates of complications and below-average episode prices. They deliver high quality and affordable care.
The 118 provider groups in the Network of Distinction are affiliated with Community Medical Group, Connecticut Gastroenterology Institute, Griffin Hospital, ProHealth Physicians, Prospect Medical and University of Connecticut Medical Group. Over the coming months, the State Comptroller’s Office will continue to expand the network with hospitals and health care providers that verifiably deliver the best health care outcomes for patients at competitive prices. Among the providers expected to join the network by the end of 2020 are Bristol Hospital, Middlesex Hospital, Nuvance Health and Women’s Health Connecticut.
“Through this program, our care teams have both data and actionable insights they can apply immediately to help improve patient health along their care journey in real time,” said Joseph Quaranta, MD, President, Community Medical Group. “We are honored to be part of a program that supports our commitment to provide superior, high-value clinical care and that allows us to spend more time focusing on what is most important— caring for our patients.”
“We are pleased to participate in this innovative program,” said Patrick Charmel, CEO of Griffin Hospital. “It showcases the tremendous value Griffin Hospital offers with its best-in-class quality, exceptional patient experience and highly competitive pricing. The broader focus of the programs model motivates us to effectively manage the entire episode of care by incentivizing greater efficiency and better outcomes.”
State health plan members, including municipal members participating through the Partnership Plan, are encouraged to contact Health Navigator to locate a Network of Distinction provider or location.