Health systems are at the center of change in today’s healthcare environment.
As hospitals are trying to make the transition away from fee-for-service and volume-driven health care to population health, the challenge is ensuring goals and incentives are aligned.
What compounds the challenge of this transition phase is that Medicare and Medicaid are growing every year as an overall percentage of payment to hospitals, but the actual payments per patient encounter are shrinking due to the ACA and the 2013 BBA Sequestration cuts. Commercial payment increasingly cannot make up for that difference as it used to.
As Health Systems transition to global payments, through either bundling, full capitation models or risk-based incentive payments, Equality Health can be a partner to help with that transition. Our risk-bearing infrastructure and population health technology platform for professional services match up well with institutions who are seeking greater value-based payment opportunities.
Our Hispanic Care Partnership model allows Equality to team up with a partner hospital in targeted Zip Codes and approach the payer community with an alliance for managed care delegated risk contracting for their Hispanic members. Further, by enrolling a Hospital’s owned and affiliated physician groups into the Equality Health Network, there is an opportunity to create greater scale, integration and performance network design at the community level.
Equality Health is not an Accountable Care Organization and therefore does not compete with Health System’s who have made investments in ACO’s.
Our services are focused on transitions and coordination of care, admission and readmission rates, emergency department and urgent care utilization, patient satisfaction across the continuum of care, and can help reduce the leakage to other health systems.