Partners Healthcare, the Bay State’s largest private-sector employer and the parent corporation for Martha’s Vineyard Hospital, plans to substantially decrease its fee-for-service business and boost alternative payment models over the next five years, as it announced plans last week to join a national effort aimed at “improving outcomes and lowering costs” in health care.
Currently about half of Partners’ primary care business is under the fee-for-service model, and by 2020 the organization plans to reduce that figure to 25 percent, with the other 75 percent in some form of “value-based” payment model, the State House News Service reported. The primary care business does not include referrals or emergency room visits, according to Partners.
Partners is also joining a new organization that includes other providers, as well as insurers, businesses, academics, and a patient group, that plans to work on recommendations to improve health care delivery.
The Health Care Transformation Task Force is led by Dr. Richard Gilfillan, CEO of Trinity Health, a provider organization based in Livonia, Mich.
“The recommendations will be in several areas,” Dr. Tim Ferris, Partners senior vice president for population health management, told the news service.
On Wednesday last week the group released its first recommendation on how to design the next generation of accountable-care organizations.
Some stakeholders within the health care industry are seeking to move away from the fee-for-service model toward schemes where the provider is paid a lump sum for treating a patient. Under the new models, hospitals can be put on the hook if costs grow more than expected, or join in the savings if the treatment is provided more efficiently.
“It’s got to be done carefully, and there’s a lot of details that we need to iron out,” Ferris said. He said recommendations will likely be in the area of how to create a shared savings program and how to calculate a payment “per episode.”
Because of the 2012 Massachusetts health reform law, Ferris said, there is “more pressure here than elsewhere in the country” to lower health care costs. Ferris said a reduction in the size of Partners is “not a necessary outcome of value-based payments.”
