Partners HealthCare and Tufts Health Plan have agreed on a new, four-year contract that focuses on improving the quality of care, disease management and technology to help control costs. Under the terms of the contract, payments to Partners HealthCare are tied to meeting specific goals in:
q managing chronic diseases;
w ramping up technologies that allow clinicians to provide opti-mal care;
e highly coordinated care manage-ment for our sickest patients; and
r effectively managing trends where costs are growing fastest.
The following provisions will be tracked for Partners patients:
Disease management: This contract establishes benchmarks for managing asthma and diabetes that, if met, would put Partners in the top 10 percent of all caregivers in the country. Partners also has committed to exceeding national benchmarks for managing cardiac care. By setting such a high standard, Tufts and Partners are encouraging both better care for patients and better use of resources. For example, studies show that managing care for poorly controlled diabetics brings the average annual cost per patient down $750.
New technologies to support excellent care: Partners is installing computerized provider order entry (CPOE) systems in all of their hospitals. Partners will also dramatically increase the number of its physicians using electronic medical records (EMR). Currently, only 4 percent of all hospitals in the country have CPOE systems. CPOE systems have been shown to reduce medication errors as much as 55 percent. The CPOE and EMR benchmarks in this contract will require significant investment by Partners and put Partners well ahead of the industry pace.
Tufts Health Plan is developing more streamlined processes to improve quality of claims submitted thereby reducing provider re-work and appeals.
Highly coordinated care management for the sickest patients: Statistics show that just 0.5 percent of patients account for 20 percent of all costs and 50 percent of hospital admissions. By intensively coordinating care for these patients, we can offer better care, avoid unnecessary hospitalizations and ensure wise use of health care resources.
Effectively managing high cost areas: High cost radiology tests, including MRIs and CT scans, and pharmaceuticals are two of the fastest growing drivers of health costs, both growing at double digit rates each year. The contract contains targeted provisions to control growth to below market trends in each of these areas.