The Shift in Payment Reform
The pressure to contain rising health care costs in the U.S. has led to major changes in the way insurers and the government pay for care. Traditional Fee for Service is slowly making way for “value-based” models of care that attempt to limit payment increases and shift more of the risk for the cost of health care to providers and patients.
Physicians and patients alike face daunting, almost overwhelming, choices in new payment models and complicated insurance programs. For physicians, the ability of an individual provider or a small practice to comply with new rules and regulations is, for practical purposes, nearly impossible. Physicians have neither the time nor the resources to study and understand the available options, much less comply with all the added requirements. As medical care grows more and more complex, patients often become lost in a fragmented system of uncoordinated care and confusing care choices at a time when they are the most needy and vulnerable.
ICP was formed by Hartford HealthCare in 2013 as a response to the evolving and complex healthcare market. Our mission is to help our providers and their patients thrive in this new value-based world. Our approach to success with Value-Based Care rests on four key pillars.
In January, 2023, HHC entered into an agreement with Optum to develop the Advantage Plus Network which is designed to help local provider groups improve quality care, clinical outcomes and member satisfaction through collaboration within the health care delivery system. For more information on APN-CT, please contact your Provider Relations Manager.
Create Value
We help our providers lower the cost of care, while improving the quality of care, and ensure that our patients receive all the care -- and only the care -- they need by:
- Establishing the highest quality, evidence-based standards for care for all specialties.
- Reducing variation and eliminating unnecessary, potentially harmful care.
Coordinate Care
We work with our providers, the Hartford HealthCare system and our ICP clinical teams to ensure that patient care is integrated and transitions are seamless across the entire continuum.
- Standardized reporting through Electronic Health Records.
- Tracking the progress of ICP patients no matter where there are within the healthcare system.
- Ensuring clinical Information follows the patient across the continuum of care.
Manage Risk
We ensure our value-based risk contracts support our providers to deliver the highest-quality care for patients in a financially responsible manner by:
- Negotiating fiscally sound risk contracts with payers.
- Ensuring fair reimbursement for providers in our network.
Culture & Capabilities
We teach, engage and support our ICP providers on goals and initiatives that are set around our value-based contracts, creating a connection for our providers on their role within ICP and how they can deliver better value-based care by:
- Utilizing advanced data systems to provide critical and timely information to our providers about their patients.
- Building systems to report quality and utilization information to our providers regularly.
- Developing care teams that include Care Management Nurses, Social Workers, Health Coaches, Pharmacists and Behavioral Health clinicians to supplement our provider practices by helping them manage their patients within, and beyond, the confines of the hospital or office
Our success depends on reducing the total cost of care for our patients while improving both the quality of care and the patient experience. To accomplish this, we aim to:
- Decrease hospital admissions and Emergency Room visits.
- Care for our patients more often in the office and in their homes.
- Reduce unnecessary variation in care and practice to well-known standards of care.
- Reduce disease’s total burden on society by intervening earlier in a patient’s chronic illness.
- Ensure our patients receive the latest, most proven treatments.
- Eliminate over-treatment and over-testing of our patients.