Blue Shield of California nonprofit parent company Ascendiun launched a national healthcare reform movement focused on value-based care, cost and tech advancement — and is calling on the government to help — according to a news release.
The campaign, called Worthy, aims to control costs by placing the overall healthcare ecosystem on a budget. One step toward accomplishing this goal is “eliminating kickbacks” through rebates, fees and spread pricing, the release said.
“There’s no way to get to a healthcare system that’s worthy of our family and friends, and sustainably affordable, if a whole series of companies see selling and administering drugs as a profit center,” Ascendiun CEO Paul Markovich said in a recent “Becker’s Payer Issues Podcast.”
In a report on the state of healthcare economics, Worthy outlined additional specific steps toward unlocking value-based care, including per person, per month risk-adjusted fees, per person bonuses for outcomes, per person bonuses for customer satisfaction, and per person bonuses for cost-effectiveness.
A thorough, up-to-date electronic health record is another cornerstone of the reforms, which the report claimed could result in $306 billion in annual savings. Worthy further suggested real-time prior authorizations and shared decision-making capabilities between the patient and physician to personalize care and lower costs. Health plans are capable of saving 30% to 50% on their administrative costs, Worthy’s report said.
“It really is mind-boggling to me that the most common communication mechanism … is a fax machine,” Mr. Markovich said. “Really, shame on us as health plans for not having figured out yet how to solve for that.”
Mr. Markovich was among a handful of health insurance CEOs to testify before Congress in January, covering topics like vertical integration, denials and pharmacy strategy. However, as a nonprofit CEO, Mr. Markovich’s testimony also focused on structural issues in healthcare. Following the testimony, he reiterated how the healthcare system may be resistant to change.
“I didn’t see the healthcare system willing to fix itself, and so it needed some, and needs some, tough love and direction,” he said.
The Ascendiun release said the campaign “is also focused on encouraging the federal government to pursue these changes since the healthcare industry is unlikely to adopt them on their own.”
