Advancing Value-Driven Contracting Models

As the healthcare industry continues to transition from volume to value, providers will need to consider and implement new care models to achieve their goals. Mount Carmel Health Partners is already doing that. Through innovative accountable care programs, we’re managing lives under broad-access, limited network, PPO, HMO, and group and individual Medicare and Medicaid products. And we’re already participating in new models like the Centers for Medicare & Medicaid Services’ (CMS) Next Generation ACO.

Through the Next Generation ACO Model, we’ve joined CMS and other ACOs across the country in sharing best practices and assuming higher levels of financial risk and reward. By taking a leadership role both locally and nationally in this innovative initiative, we plan to help achieve the model’s goals of ensuring better health, higher-quality care and lower costs for individuals and communities.

The Next Generation ACO Model isn’t the only new initiative we’re working on. We’re currently involved in a number of transformational projects like these:

  • New HMO products sold on and off the Health Insurance Marketplace.
  • A Mount Carmel Colleague ACO, which covers Mount Carmel employees and their dependents and features a tiered network incentivized through benefit design.
  • Direct-to-employer payment models and integrated workplace health solutions.
  • Bundled Payments for Care Improvement (BPCI) as part of a broader Mount Carmel Health System initiative to manage episodes of care for Medicare beneficiaries across 35 bundles.
  • The Medicaid State Innovation Model, which supports Ohio Health Transformation initiatives.
  • A Medicaid Emergency Department Redirection Program.

Contracting models like these are crucial to advancing our goals of improving quality and the patient experience, improving population health, and making care more affordable. Health Partners is fully committed to these initiatives and remaining a value leader in central Ohio healthcare.