|Foundation Awards $1.3 Million To Integrated Healthcare Association
Blue Shield of California Foundation (BSCF) has awarded
a $1,328,000 medical technologies grant to the Integrated Healthcare
Association (IHA) to implement statewide collection of comparative
data; evaluate purchasing and payment systems; and develop a new
episode-based payment method for medical device purchasing.
The grant helps to align physician and hospital
interests that are now divided through the practice of
direct-to-physician vendor incentives, and is part of the
foundation’s health and technology program strategy to promote
evidence-based clinical best practice and technology adoption among
California providers, BSCF said.
"By improving the quality and transparency of the data
available regarding medical device use, the IHA project will
incentivize surgeons, hospitals, health plans and the medical device
industry to work collaboratively to enhance the value of specialty care
delivery in California and throughout the nation," said Dr. Kevin J.
Bozic, associate professor in residence University of California, San
Francisco Department of Orthopaedic Surgery and Institute for Health
Although IHA is better known for its California
pay-for-performance program, it recently completed a two-year value
assessment and purchasing project in Orange County, also funded by
BSCF, to improve data transparency and payment methods for high-value
medical devices, including orthopedic and cardiac implants, in the
California healthcare system, BSCF said.
"IHA has a successful history of multi-stakeholder
collaboration among hospitals, physician organizations and health
insurance plans," said Crystal Hayling, president and CEO, BSCF. "The
grant is awarded to IHA to evaluate medical technology used in
cardiology and orthopedics, providing California hospitals with
information that will be used to help improve quality of care,
purchasing methods and payment systems."
Building on the insights from the regional pilot project, the grant allows IHA to:
- Aggregate comparative data for benchmarking quality
and costs, identify best practices strategies for value assessment and
begin a statewide hospital technology collaborative; and
- Explore new financial incentives, potentially
including payment methods for hospitals when purchasing devices for
manufacturers and for health insurers when reimbursing hospital claims,
e.g., through bundled "episode of care" pricing.
The episode-based payment method will be piloted by at
least one health plan with participating hospitals, and these
experiences will be documented and disseminated to health plans and
providers with statewide support from key stakeholders, BSCF said.
Medical device purchasing processes have received
greater national attention regarding physician conflicts of interest
with medical device companies. Hospitals want benchmarking data and
need to adopt best practice strategies to lower medical device costs.
Health plans also find it difficult to keep pace with the increasing
hospital costs for orthopedic and cardiac implants, especially when
their contracts carve out the device, BSCF said.
Addresses: Blue Shield of California Foundation, 50 Beale St., San Francisco, CA 94105; (415) 229-5000, www.blurshieldfoundation.org. Integrated Healthcare Association, 3 Thomas L. Berkley Way, Suite 350, Oakland, CA; (510) 208-1740, www.iha.org.