Package pricing: Geisinger's new model holds the promise of aligning payment with optimal care
Geisinger Health System and Geisinger Health Plan have attracted attention from key industry players ever since introducing a bundled-pricing program called ProvenCare in 2006. Richard Gilfillan, MD, president and CEO of Geisinger Health Plan, played a critical role in the launch of the new payment structure.
Current healthcare pricing "cannot be understood by a human being with average intelligence or limited patience," according to Leavitt. He believes the industry must overcome the notion that healthcare pricing should be different than other goods and services.
In fact, the Medicare Payment Advisory Commission is evaluating how Medicare might pay providers single prices for episodes of care and is urging Congress to enact legislation as such. Routine surgery prices, for example, might bundle the cost of the surgery, the hospital stay, the anesthesiologist and other related therapy into one price. And providers could bid competitively for Medicare's business.
"We had two teams, a clinical team and an insurance team," Dr. Gilfillan says. "My role was to think through the implications of this from the reimbursement side and help our folks structure the analysis that led to determining the appropriate global rate for pricing."
Breaking Down Health Plans, HSAs, AI With Paul Fronstin of EBRI
November 19th 2024Featured in this latest episode of Tuning In to the C-Suite podcast is Paul Fronstin, director of health benefits research at EBRI, who shed light on the evolving landscape of health benefits with editors of Managed Healthcare Executive.
Listen
In this latest episode of Tuning In to the C-Suite podcast, Briana Contreras, an editor with MHE had the pleasure of meeting Loren McCaghy, director of consulting, health and consumer engagement and product insight at Accenture, to discuss the organization's latest report on U.S. consumers switching healthcare providers and insurance payers.
Listen
