State News

Illinois | Aug 7, 2016 | News Story

Blue Cross and Blue Shield of Illinois to Launch New Value-Based Care Model

The Blue Cross and Blue Shield of Illinois and the largest independent physician practice in Chicago, DuPage Medical Group, will launch a new value-based care model, according to the HIT Consultant. The model ties payment to quality and performance measures.


Illinois | Aug 7, 2016 | News Story

Blue Cross and Blue Shield of Illinois Launches New Value-Based Care Model

Blue Cross and Blue Shield of Illinois and the largest independent physician practice in Chicago, DuPage Medical Group, will launch a new value-based care model, according to HIT Consultant. The model ties payment to quality and performance measures, and the model will provide quality and cost data to inform population health management decisions.  


Washington | Aug 5, 2016 | News Story

Washington Sets Ambitious New Goals for Value-Based Care

State of Reform reports that the Washington Health Care Authority’s (HCA) new 1115 Medicaid waiver application is seeking to tie 30 percent of its healthcare purchases to value-based arrangements by next year, and 90 percent by 2019. HCA will implement seven performance measures that complement the waiver process. HCA will withhold one percent of a managed care plan’s premiums based on their performance against these measures which can be earned back by producing favorable scores for quality, patient experience, and cost of care.


Mississippi | Aug 4, 2016 | News Story

Major Increases Expected for Miss. Humana Policyholders Under Federal Exchange

For 2017, Humana’s monthly exchange premiums are expecting to increase, on average, by 43 percent, according to Mississippi News Now. Rate increases are likely a result of growing healthcare and prescription drug costs, higher use of inpatient services, and the phasing out of premium stabilization programs implemented by the Affordable Care Act, according to the article.


Texas | Aug 3, 2016 | News Story

Bundled Payments Generate $6.1 Million for Texas Hospital Group on Joint Replacements

A Texas hospital group generated an average savings of $284 per joint replacement in a demonstration that features a bundled payment for joint replacements, according to The Commonwealth Fund.  Physician were guaranteed Medicare payment rates and offered bonuses of up to 25 percent. Program success relied on physician engagement, which was achieved through establishing individual and group gainsharing thresholds supported by transparency for physician level cost and quality data.


New Jersey | Aug 3, 2016 | News Story

New Jersey to Test How to Reduce Healthcare Costs, Improve Quality

New Jersey was one of fourteen states recently selected by the Centers for Medicare and Medicaid Services to participate in a five-year program aimed at overhauling the way in which healthcare providers are paid by insurers, according to NJ Spotlight.  The Comprehensive Primary Care Plus (CPC+) program builds on an existing initiative in allowing Medicare and participating private insurers to pay providers according to one of two different value-based payment models.  The project is expected to impact as many as 20,000 physicians and 3.5 million patients nationwide.


Alaska | Aug 2, 2016 | News Story

How Health Care Costs are Bleeding Alaska Dry

A 2013 study by the Anchorage School District found that the majority of state spending increases went to healthcare and pensions and that health spending was more than double the national median despite below-average utilization levels. The dramatic increase in spending is primarily associated with the increasing price of goods and services, according to Alaska Dispatch News.


Illinois | Aug 2, 2016 | News Story | Rate Review

Insurers in Illinois Seeking Rate Increases Ranging from 23 percent to 45 percent in 2017

Blue Cross Blue Shield, a leading insurer on the Illinois’ exchange, is seeking increases as high as 45 percent for individual health plans beginning in 2017, according to Crain’s Chicago Business. The Illinois Department of Insurance has until August 23 to review proposed hikes.


Illinois | Aug 2, 2016 | News Story | Consolidation

Advocate and Northshore Healthcare Systems Say FTC Can’t Block Merger

For months Advocate Healthcare and Northshore University Health system  have been seeking to combine services but have been halted by the FTC. According to Modern Healthcare, both health systems say that the FTC has no economic or factual basis to challenge the proposed merger. The FTC continues to file appeals blocking the merger.  


New York | Aug 1, 2016 | News Story

New York Health Department, United Hospital Fund Outline Plan to Expand PCMH Model

The New York State health department has released a plan that will expand and improve access to primary care medical homes across the state, according to a United Hospital Fund Press Release.  The plan hopes to guide New York in adopting a delivery model that improves quality and value of care.  The adoption of this model is also in line with New York City’s Take Care New York 2020 goals.