June 15, 2012
IBM: Improving Health Care Value and Innovation Through Integration, Benefits Coverage and a Focus on Primary Care
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The foundation of IBM’s approach to driving value and innovation in the health care delivery system is primary care transformation. IBM’s leaders believe that the primary care medical home model is a promising catalyst for overall health care delivery system reform.
Innovation in clinical care programs, prevention and smart health care utilization has created significant gains in health care value at IBM. Since 2004, the company has saved $1 billion in employee health care costs, and between 2004 and 2007, reduced the high-risk population by 55 percent. The key drivers of change at IBM include:
- Employing a cutting-edge purchasing strategy;
- Redesigning health plans to make prevention and primary care free coupled with strong behavioral and clinical care using the preferred provider organization (PPO) model;
- Focusing on an employee-centric allocation of IBM investment providing zero premium benchmark PPO for employees, competitive premiums for dependents and buy-up options for those with predictable high health care needs;
- Ensuring employee cost sharing keeps pace with inflation by using coinsurance and increasing fixed dollar cost sharing by plan trend;
- Putting in place an award-winning wellness strategy that provides healthy living rebates for innovative web-based programs, onsite screenings and immunizations; and
Making investments in prevention, primary care, behavioral health and chronic disease management.
- The company believes that primary care should include a personal physician, payment reform, enhanced access, quality and safety, integrated care, a “whole person” holistic orientation and physician-directed medical practice.
As part of its case for reform, IBM notes that primary care medical home interventions are producing promising results on a national level, including a 36.3 percent decrease in number of days for hospital stays; a 32.2 percent decrease in emergency room use; and a 10.5 percent decrease in specialty care costs, among others.
- The company is utilizing its leadership position to address the market failure in primary care through the Patient Centered Primary Care Collaborative (PCPCC) — a 900-member coalition of diverse stakeholders including employers, health plans and patient advocacy groups committed to primary care.