MN direct contracting experiment working
Employees in an innovative Minneapolis direct contracting program have voted with their feet in terms of price and patient satisfaction criteria, Managed Care Week reports.
The program, sponsored by the Buyers' Health Care Action Group, allows employees of the market's 26 largest employers to purchase health care through a competing care system model. During open enrollment season, employees choose their benefits by selecting a provider group rather than an insurer. The same HMO, HealthPartners, administers all contracts.
During this year's open enrollment system, all the lower-cost provider systems gained market share, ranging from 15% to 58%. Market share gains by medium-priced care systems ranged widely, from a high of 31% to a low of -2%. The best of the high-cost care systems had a 3% gain in market share, while the least successful lost 18% of patients employed by Buyers' Action members.
However, customer service also played a role in patient choice. Among the medium-cost care systems, the one with the highest quality indicators also had the greatest gain in market share. In addition, the only high-cost system to increase market share also had consistently high patient satisfaction ratings.
Most providers participating in the Buyers' Action program raised premiums in 1998, the second year of the program, as market share did not correspond to the price discounts they gave Buyers' Action during the first year of the program.
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