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Partners announces agreement with Harvard Pilgrim

  • Agreement includes global payment arrangement.

Partners reaches new agreement with Harvard Pilgrim

New Contract Includes Global Payment Model to Help Slow Cost Growth

10/25/2012

Partners HealthCare today announced that it has reached an agreement with Harvard Pilgrim Health Care (HPHC), which includes a new global payment arrangement, aimed at slowing the rate of cost growth for consumers. As a result of this agreement, Partners HealthCare is now participating in alternative payment models with all three of Massachusetts' largest commercial insurers. Additionally, Partners is working with the federal government as part of an innovative pilot initiative to slow cost growth for Medicare patients.

The HPHC agreement is a renegotiation of an existing contract and achieves two major objectives:

  1. Partners is entering into HPHC’s global payment model, and will be required to meet or exceed quality measures for its patients. The global payment model includes a spending target that is in line with the state’s goal to keep cost growth at or below the increase in the state gross product as directed by the recently signed health care cost containment law.
  2. Rate increases will be held in line with general inflation, which is presently about 2 - 3 percent.


“Our patients expect us to work with insurers, government leaders and members of the health care community to improve quality and slow cost growth,” said Gary L. Gottlieb, MD president and CEO of Partners HealthCare. “With this agreement, Partners is now participating in a new model of care with the three largest commercial insurers in the state. With our participation in the Medicare Pioneer ACO, Partners now cares for more than 500,000 individuals under new, alternative payment models that focus on value for our patients and their families.”

During the past year, Partners announced that it had renegotiated existing contracts with Blue Cross Blue Shield of Massachusetts as well as Tufts Health Plan, entering Partners into a global payment and risk sharing arrangement with those insurers.

Partners was also recently selected as one of just 32 health care providers in the nation as a Pioneer Accountable Care Organization (ACO). The initiative, sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, aims to transform the way that health care is delivered by providing Medicare patients with higher quality, while slowing cost growth through enhanced care coordination.

These agreements are possible as the result of sweeping initiatives that Partners has put into place to redesign the delivery of care at Partners to both improve quality and reduce costs. “Massachusetts can and should serve as a model for the rest of the country on cost control,” said Gottlieb, “as we are on improving quality and access to health care.”


Media Coverage

The Boston Globe

Boston Business Journal


About Partners HealthCare

Partners HealthCare is an integrated health system founded by Brigham and Women’s Hospital and Massachusetts General Hospital. In addition to its two academic medical centers, the Partners system includes community and specialty hospitals, a managed care organization, community health centers, a physician network, home health and long-term care services, and other health-related entities. Partners is one of the nation’s leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School. Partners HealthCare is a non-profit organization.

 

 

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