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ADVANCING VALUE-DRIVEN CONTRACTING MODELS
As the healthcare industry continues to transition from volume to value , providers will need to consider and implement new care models to achieve their goals . Mount Carmel Health Partners is already doing that . Through innovative accountable care programs , we ’ re managing lives under broad-access , limited network , PPO , HMO , and group and individual Medicare and Medicaid products . And we ’ re already participating in new models like the Centers for Medicare & Medicaid Services ’ ( CMS ) Next Generation ACO .
Through the Next Generation ACO Model , we ’ ve joined CMS and other ACOs across the country in sharing best practices and assuming higher levels of financial risk and reward . By taking a leadership role both locally and nationally in this innovative initiative , we plan to help achieve the model ’ s goals of ensuring better health , higher-quality care and lower costs for individuals and communities .
The Next Generation ACO Model isn ’ t the only new initiative we ’ re working on . We ’ re currently involved in a number of transformational projects like these : » New HMO products sold on and off the Health Insurance Marketplace . » A Mount Carmel Colleague ACO , which covers Mount Carmel employees and their dependents and features a tiered network incentivized through benefit design . » Direct-to-employer payment models and integrated workplace health solutions . » Bundled Payments for Care Improvement ( BPCI ) as part of a broader Mount Carmel Health System initiative to manage episodes of care for Medicare beneficiaries across 35 bundles .
» The Medicaid State Innovation Model , which supports Ohio Health Transformation initiatives . » A Medicaid Emergency Department Redirection Program .
Contracting models like these are crucial to advancing our goals of improving quality and the patient experience , improving population health , and making care more affordable . Health Partners is fully committed to these initiatives and remaining a value leader in central Ohio healthcare .
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