Via Christi Health and Coventry Health Care are teaming up for a pilot project they hope will save money, improve quality and position them for the new realities of health care.
Kevin Conlin, president and CEO of Via Christi Health, and Mike Bahr, executive vice president of Coventry Health Care, talked Thursday about how their Medicare pilot project came to be during an Innovation Learning Network meeting in Wichita.
The meeting brings together a consortium of health care leaders to talk about innovation and collaboration.
Conlin and Bahr said health care legislation is forcing providers and insurers to "look at how the world is going to change," as Bahr put it.
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The Affordable Care Act means more individuals will be buying insurance on their own in future years, they said, so cost and quality will become more important as insurers and providers compete for customers.
"We've got to find ways to improve the quality and share the gain," Bahr said.
Via Christi and Coventry hope to do that with the launch Jan. 1 of Advantra Total Care, a new Medicare Advantage insurance product that Coventry began marketing Oct. 1.
Coventry hopes to enroll 2,000 to 3,000 Sedgwick County residents in the plan, which will use Via Christi Medical Associates physicians to provide medical homes for the customers.
Coventry and Via Christi have agreed on evidence-based care, prescription formularies and other issues that often separate insurers and providers, Conlin and Bahr said.
They are focusing on Medicare beneficiaries for the pilot project because that group of people has similar health needs, they said, and the potential for market growth is significant.
Employers want large provider networks to meet the needs of employees, they said. But employer-based insurance will become less widespread, particularly for small employers, Bahr predicted.
And products marketed to individuals, especially those with similar health needs, can make use of smaller provider networks, such as the Via Christi physicians.
In addition, payment incentives and profit sharing parts of the plan require a smaller network, Bahr said.
Conlin said Via Christi and Coventry hope the pilot project will help them learn how to empower primary care physicians, how to collaborate and how to work with physicians on incentives.
"It's our hypothesis that this is the right way to deliver care in the future," Conlin said.