State of Connecticut’s New Episodes of Care Health Plan Could Be Key to Scaling Value Care – The Health Care Blog

By JESSICA DaMASSA, WTF HEALTH

Signify Health (NYSE: SGFY) named their approach “Value-Based Care 2.0” and today received a major award from CMS that could set an exciting precedent for scaling episode-of-care, value-based models for the commercial health insurance market under 65 years of age. The plan to receive this important Advanced Alternative Payment Model (AAPM) approval is the Connecticut State Health Plan – a comprehensive plan that covers the state’s 220,000 employees and retirees. To discuss what this first approval of its kind signals for the future of value-based payment models, Connecticut State Auditor Kevin Lembo and Signify Health CEO Kyle Armbrester.

What is so important here is the combination of episodes-of-care (which is like Value-Based Care-Lite) and the under 65 market (which is not as rich in value-based care case studies as the Medicare market over 65 years). ). It is important that a state government with a massive population of insured lives AND a vested interest in keeping local hospitals and health systems in the community alive, lead the way in this novel payment model design. And Comptroller Lembo gives us the details on how he sees it as a win-win – after a few fights along the way. To win in health innovation, you have to follow the dollar! Turn this chat on to see where it’s headed as episode-of-care models are getting a huge boost from CMS.