Allina Health, a 12-hospital not-for-profit health system in Minneapolis, Minnesota, has expanded its relationship with MedAssets to better align hospital and physician reimbursement strategies across the care continuum.
The system has chosen to extend the use of MedAssets’ Contract and Episode Management Solutions into outpatient settings, to increase the longitudinal view of patient care to better manage cost, contracting and quality.
As a part of its move to prepare for accountable care organisation (ACO) delivery models and new payment methodologies that encompass, in one payment, the services from pre-acute, acute and follow-up care providers, the health system has expanded its relationship with MedAssets.
The Patient Protection and Affordable Care Act includes several payment reform initiatives that encourage physician-hospital integration, including ACOs.
Allina Health is planning to incorporate insight from both hospital and professional claims obtained from MedAssets contract modelling tools into its contract negotiations.
This analytical insight factors in patterns of reimbursement in order to minimise financial exposure and payor underpayments, and identify savings opportunities.
Contract and Episode Management Solutions will help the system to bridge the gap between traditional fee-for-service and fee-for-value reimbursement.
Allina Health Finance, Payer Relations and Value Analysis manager Lee Peterson said the system has seen significant benefits from MedAssets’ Contract Management and Modelling tools in the past ten years.
"Expanding our relationship with MedAssets for their episode of care solutions is a natural next step as we ramp up our ACO strategy and expand as a value-based organisation," Peterson added.
In addition, Allina Health will prepare for upcoming reimbursement changes due to healthcare reform with additional interoperable solutions – Contract Management Professional and Prospective Episode Manager – to provide management of multiple contracting methodologies under a value-driven model.
MedAssets COO Mike Nolte said value-based payment models are designed to facilitate better coordination of care across settings and align financial incentives.
"Accountable care delivery creates a dramatically more complex reimbursement environment. MedAssets’ Contract and Episode Management Solutions, as well as our breadth of performance improvement solutions, can serve as integral components in developing care management business strategies to compete with these new market factors," Nolte added.
Allina Health owns or operates 12 hospitals, 14 pharmacies, specialty care centres and specialty medical services and more than 90 clinics throughout Minnesota and western Wisconsin.