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Related Experiment Videos

Direct contracting: a Minnesota case study.

S N Burrows1, R C Moravec

  • 1HealthEast Care, Inc., St. Paul, MN, USA.

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
|July 6, 1997
PubMed
Summary
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HealthEast Care: a direct contracting company.

Managed care quarterlyยท1997
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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.

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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.