Drew Hobby

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Across the nation, the rising cost of healthcare continues to lead the discussion in the newspaper, at the family dinner table, and around the workplace water cooler.

The high cost of care impacts everyone: uninsured middle-class families, providers, hospitals, and seniors. Businesses that provide health insurance benefits to employees often have a larger share of the cost burden.

In the last ten years, Idaho businesses have seen a 54.7 percent increase in monthly cost for each employee. Blue Cross of Idaho believes that healthcare needs to be easier to afford for Idaho families and Idaho businesses. We are proud to offer solutions to employers like transparency tools and employee wellness programs that improve employee health outcomes and save business owners money.

We know employers want to offer a high-quality health plan at an affordable cost. That’s why we’re leading the state in moving from the old fee-for-service system to a new value-based payment model.

Value-based care lowers the cost to employers, and pays physicians for delivering high-quality, cost-effective care.

Since 2016, we’ve worked with providers in Idaho to shift the way they are paid for their work. Currently, many providers work in a fee-for-service system that pays them based on the number of patients they see and the number of healthcare services they provide. The system does not pay a physician for healing his/her patient or for coordinating a patient’s overall care.

Earlier in the year, we announced new value-based care payments with seven top provider groups across Idaho.

The results are clear: value-based care improves health outcomes for patients while lowering costs for employers and individuals. In fact, our data shows that there was a 15 percent reduction in surgery claims and emergency room use was 41 percent lower for our members in a value-based system.

In our value-based care system, doctors and hospitals share the risk and savings with health plans and employers. Providers, patients and insurers work together to:

• Coordinate care with other providers

• Reduce unnecessary tests or procedures

• Use evidence-based, lower-cost care

• Know cost trends and best practices

Providers share in savings when they exceed established cost and quality targets for clinical and preventive services. If a provider does not exceed those targets, he/she loses a financial incentive.

A value-based care arrangement makes sense for employers because they save on claims, and their employees have a better healthcare experience with better coordination of care.

Idaho doctors already deliver excellent care, but to lower costs for business and patients, we need a system that supports better health outcomes, rewards efficiency and encourages more competition.

Value-based care represents the future of healthcare payment trends, and we are happy to be leading the curve.

Drew Hobby is senior vice president for healthcare economics and provider services.

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