Value-Based Health Care Payment Model Takes Root in Southwest Idaho

Saint Alphonsus Regional Medical Center in Boise and Saint Alphonsus Medical Center in Nampa work with Regence BlueShield of Idaho to implement “value-based” reimbursement model

St Alphonsus-Boise
83702 —

BOISE, Idaho – The decades-old practice of basing payments for hospital-based care on the volume of services provided is rapidly fading in popularity. In its place, new approaches that focus on quality improvement and greater affordability are gaining momentum. Just this month, Saint Alphonsus Medical Centers in the Treasure Valley agreed to introduce Value-based Reimbursement as part of their agreement with Regence BlueShield of Idaho.

Regence’s Value-based Reimbursement model ties reimbursement to hospital performance on specific quality measures. The measures typically include such leading national standards as the hospital’s STAR “quality” rating from the Centers for Medicare and Medicaid Services (“CMS”) Hospital Consumer Assessment of Healthcare Providers and Systems; and the CMS Hospital Consumer Assessment of Healthcare Providers and Systems survey of patient experience.

By 2018, the U.S. Department of Health and Human Services will base 50 percent of its Medicare reimbursements to providers on performance against value-based measures. Rather than wait for the government-driven changes, Saint Alphonsus and Regence decided to get ahead of the curve.

“We have a deep and long-standing commitment to lead the way with innovation that benefits patients across our service area,” said Rodney Reider, Saint Alphonsus Health System president and CEO. “Whether it’s the introduction of new clinical techniques, refining our capabilities as the region’s trauma center or improving our business practices, our record of delivering ever-greater value and outcomes is second to none.”

“Being able to work with a health care partner like Saint Alphonsus  to implement Value-based Reimbursement has been a really positive experience, said Scott Kreiling, president of Regence BlueShield of Idaho. “It’s clear that the hospital system has exceptional processes and practices in place, and welcomes the opportunity to be measured against high national standards and to continually focus on patient concerns about cost, quality and transparency.”  

With Saint Alphonsus Medical Center’s regional leadership on value-based payments, Regence members in Idaho can now choose from a committed network of high quality, affordable hospitals that put patient experience, patient outcome and manageable costs first in virtually every part of the state.

About Saint Alphonsus Health System

As a faith-based Catholic ministry and not-for-profit health system, Saint Alphonsus Health System reinvests in the communities we serve, through charity care and other benefits. Our goal is to improve the health and well-being of people by emphasizing care that is patient-centered, physician-led, innovative and community-based. Saint Alphonsus Health System serves the people of southwestern Idaho, eastern Oregon and northern Nevada through these facilities: Saint Alphonsus Regional Medical Center – Boise, ID; Saint Alphonsus Medical Center – Nampa, ID; Saint Alphonsus Medical Center – Ontario, OR; Saint Alphonsus Medical Center – Baker City, OR; and, Saint Alphonsus Medical Group with primary and specialty care providers at over 60 clinic locations, all of which are members of the Saint Alphonsus Health Alliance, a network of over 1,900 employed and independent providers. Saint Alphonsus is a proud affiliate of Trinity Health, one of the largest multi-institutional Catholic health care delivery systems in the nation. Trinity Health serves people and communities in 21 states from coast to coast with 88 hospitals and 126 continuing care facilities, home health and hospice programs, and PACE center locations that provide more than 2.5 million visits annually. To find out more go to:  www.saintalphonsus.org
 

About Regence BlueShield of Idaho

Regence BlueShield of Idaho, based in Lewiston, has been serving Idahoans for 70 years and now provides more than 141,000 members with comprehensive health insurance solutions. As a nonprofit mutual insurance company and independent licensee of the Blue Cross and Blue Shield Association, Regence is part of a family of companies dedicated to transforming health care by delivering innovative products and services that change the way consumers in Idaho and nationwide experience health care. For more information, please visit regence.com,facebook.com/regenceblueshieldofidaho or twitter.com/regenceidaho.