Employer-Led Innovation for Healthcare Delivery and Payment Reform
As the Institute of Medicine noted in 2012, healthcare costs in the United States rose 88 percent in the past decade and now consume approximately 18 percent of the U.S. Gross Domestic Product (GDP). Yet waste and lack of coordination are pervasive throughout the system, and outcomes are significantly below those of other developed nations.
Employers are key stakeholders in the healthcare ecosystem. They hold the purse strings for much of the cost of employees’ health insurance and often determine which benefits employees’ access. They can also be effective advocates for employees and their dependents in a complex healthcare system where care is often fragmented. To date, however, employers have largely limited their influence to wellness and disease management programs and contract negotiations with insurance companies.
After a decade of applying the usual levers to improve its employees’ health and contain rising healthcare costs, Intel believes it is time for employers to work more directly to transform the payment and delivery systems for healthcare. In an innovative program with Presbyterian Healthcare Services (PHS), Intel has engaged directly and deeply in benefit design, plan design, and delivery optimization for employees and dependents at its Rio Rancho, New Mexico, facility. Intel and PHS have established a custom Integrated Delivery System (IDS) model of shared risks and rewards—essentially an employer-sponsored Accountable Care Organization (ACO) based on a patient-centered medical home (PCMH) model—that aims to give Intel employees more personalized, evidence-based, coordinated, and efficient care. This program, called Connected Care, moves beyond fee-for-service models to more effectively incent desired behaviors and results.
Connected Care is inspired by Intel’s vision of having the healthiest workforce on the planet and making healthcare a strategic business and people advantage for the company. Intel and PHS believe Connected Care is also a demonstration of sustainable, system-wide changes that can improve access to high-quality, efficient, and affordable care.
Connected Care went live as an operational health plan and delivery system for Intel employees in New Mexico on January 1, 2013. In addition, Intel is establishing PCMH pilots with local providers in other regions to more fully engage members in managing their health and transforming system delivery.
Read the full Employer-Led Innovation for Healthcare Delivery and Payment Reform White Paper.