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Direct contracting: a Minnesota case study.
1HealthEast Care, Inc., St. Paul, MN, USA.
Summary
HealthEast Care successfully partnered with Buyers Health Care Action Group (BHCAG) to offer healthcare services. They developed a unique payment model balancing costs and expectations for over 117,500 members.
Area of Science:
- Healthcare Management
- Health Economics
- Contracted Healthcare Services
Background:
- HealthEast Care, Inc. is a direct-contracting healthcare provider.
- Buyers Health Care Action Group (BHCAG) is a coalition of self-insured employers.
- BHCAG sought healthcare services for its Choice Plus health plan members.
Purpose of the Study:
- To outline HealthEast Care's proposal for BHCAG's healthcare needs.
- To detail a novel payment model for healthcare services.
- To demonstrate a successful provider-purchaser collaboration.
Main Methods:
- HealthEast Care developed a care system proposal.
- A fee-for-service, budget-based payment model was implemented.
- Contract negotiations were established between BHCAG and multiple care systems.
Main Results:
- HealthEast Care was selected by BHCAG to provide services.
- The proposal successfully balanced consumer and purchaser expectations with costs.
- The contract served over 117,500 Choice Plus enrollees across Minnesota.
Conclusions:
- HealthEast Care's model proved effective in meeting BHCAG's requirements.
- The collaboration highlights successful direct contracting in healthcare.
- The budget-based payment model offers a viable alternative for healthcare provision.