General News
Published July 15, 2019
A common concern for those seeking healthcare is paying too much for services and not getting the care they need.
To address this problem, Premera is reimagining our provider relationships to help deliver for high-quality care at a reasonable price.
What is value-based care?
Compensation models in healthcare are actively shifting from traditional fee-for-service payments to value-based care. Under a fee-for-service payment model, providers receive a fee for each test or procedure, which can drive up costs. Value-based reimbursements reward providers for the best patient outcomes.
Why is it important?
These new payment models are built on a relationship of trust and a shared goal of slowing down the increase in the cost of care. It also requires shared data and analytics.
“Value-based care allows a provider to get off the treadmill of fee-for-service visits and provide the care they were trained for and want to do for patients,” explains Dr. David Buchholz, medical director at Premera.
For members, this approach to care generally results in lower out-of-pocket costs. More efficient treatment can mean lower costs for employers, too.
How does Premera do this?
More than half of the payments that Premera makes to providers are tied to value. In 2018, 58% of Premera medical claims dollars were paid under a value-based contract.
Action you can take
When it comes time to begin thinking about your employee benefits budget and renewing your health plan with Premera, consult with your producer or Premera representative. They can provide information to help you better understand what Premera is doing to make it easier for your employees to get access to value-based care.