Spectrum Health is one of four pilot sites to pioneer payment reform model for health care services

By Sharon Hanks

Grand Rapids' Spectrum Health is one of four pilot sites nationwide selected to participate in a new payment model for health care that may transform the way providers are reimbursed for care while offering greater efficiency and reduced healthcare costs.

Hospital officials say the model focuses on transitioning from the present a la carte system, in which providers are paid for each encounter of care, to a single all-inclusive payment structure that provides reimbursement for an entire episode of care.

"We are very pleased to be invited to be part of this," says Paula MacKenzie, Spectrum Health spokeswoman. "It's a very innovative approach and we are constantly looking for ways of coordinating care more efficiently. This is one way of doing this."

The model, often referred to as a bundled payment or the PROMETHEUS payment model, is based on delivery value-driven care with strong financial incentives to improve efficiency and encourage clinical collaborations. The goal is to streamline the payment system with a design that's more cost effective, efficient and successful.

Funded by the Robert Wood Johnson Foundation, the three-year project includes the coordination of services in each of Spectrum's business units: its hospital, medical group and health insurance plan.

"This pilot project is an opportunity to examine a payment reform approach that will benefit patients and anyone who pays for health care services," says Richard C. Breon, president and CEO, Spectrum Health in a press release. "Ultimately it means delivering the right care at the right time and in the right place for the best possible outcomes."

As part of the experiment, Spectrum Health will begin applying the piloted payment methodology in the last year of testing to patients receiving care for congestive heart failure, diabetes, colon surgery, asthma and chronic obstructive pulmonary disease.

The other sites are in Minnesota, Illinois and Pennsylvania.

Sources: Paula MacKenzie, Spectrum Health Hospital spokeswoman; Spectrum Health website.

Sharon Hanks is innovations and jobs news editor at Rapid Growth Media. Please send story ideas and comments for the column to Sharon at [email protected]. She also is owner of The Write Words in Grand Rapids.