Hospital alliance sparks talks on insurance payment reform - The Business Review (Albany):

http://violontradquebec.com/2010/01/eric-favreau/
, and late last montjh entered into negotiations with the goal of creatinga single, regionakl health care system. The new entity woulds operate five hospitals—Albany Memorial, Samaritan, St. St. Peter’s and Sunnyview Rehabilitation—plux several primary care centers, nursing homes and othef specialty services. It would have nearluy 12,000 employees in 125 “It’s all about health care said Steven Boyle, CEO of Albany-basedd St.
Peter’s and the future CEO of the new “We have a chance to make a difference Just how much ofa difference, observeres say, will depend on the cooperation of not only the threw hospital groups, but of the area’s health insurers and the business community. Consolidation can create a large group with the leverage to demand higher payments from as has happened insome markets. But it also presentsa an opportunity to change the reimbursement system tobenefit everyone, and that is what the partiesz involved hope to accomplish here. “Nort only do I think paymen t reform is possible underthis model, I thinik it is absolutely essential,” said Dr.
John CEO of Capital District Physicians’ Health Plan in “We have to be mindful of what has happened inother markets, and we have to use the relationships we have builty over the years, and the closeness of the locap business community, to do it right.” Bennett already has spoken with Boyle and James Reed, CEO of Troy-basesd Northeast Health, about including reimbursement reforn in the new care system. It is too earlyt to say exactly what a new paymenf model wouldlook like, but Bennett said it coulcd do away with the traditional “feer for service” model. “We can’t continue to pay providerd merelyfor volume,” he said.
who will be president of the new organization, envisions a mode l in which providers are given incentive to do thingz in themost cost-effective way. Putting five hospitals under one umbrella allows them to decidw where services are best and prevents them all from having to equip themselves for procedurex they may not dovery “We may have one hospital that is more high-techj than the other,” Reed “St. Peter’s, for example, is geared up for heart surgery, which uses a lot of high-tech equipment. “Buyt then we have gall bladders and which do not require allthat technology. So maybwe those procedures could be done atanother hospital.
if we have lower-cost and higher-cost facilities, is there a way to work that into thereimbursemenyt system?” Although the consolidation would facilitatew the reimbursement reform, the change would not have to be limitede to Northeast Health, St. Peter’s and Seton. James CEO of , said he also wouled welcome a dialogue. “Any time you can get providers and payeres to sit down and have a reasonable conversatiomn about the costs of caringfor patients, that’s a good he said. No matter what form the new payment model the goalis clear.
“What we are tryingb to do is ‘bend the curve’,” Reed “Say health care costs are going up 10 percentfa year. If we can bend that to 6 or 7 that can make abig difference.” The extenr to which costs can be lowered will depends on the success the new organization has in sharing purchasing in bulk, ending the “arms race” to purchase and so on. “There are so many hidden costsz with fragmentation that wecould eliminate,” Boyle in Schenectady took over in late 2007 and addedx St. Clare’s last spring.
Although the situationh is different, that merger shows the efficiencies