The
partners will be focusing on wellness as much as they focus on illness and
emphasized that the health plan will be provider-led.
April 14, 2021 - MVP Health Care and the
University of Vermont (UVM) Health Network plan to form a Medicare Advantage
plan with an emphasis on wellness, the non-profit payer and academic healthcare
system announced.
“With a shared mission of creating innovative solutions and
sustaining healthy communities, MVP Health Care and the UVM Health Network will
enthusiastically co-create a health plan that supports stronger relationships
between members and physicians, and will positively impact the communities we
serve,” said Christopher Del Vecchio, president and chief executive officer of
MVP Health Care.
The health plan will be available to residents in Vermont
and the northern region of New York. Beneficiaries will be able to enroll in
MVP Health Care and UVM Health Network’s plan during open enrollment of 2022,
with the benefits going into effect on January 1, 2022.
While the granular details will not be available until open
enrollment, the health systems indicated a couple of key aims for the new plan.
The MVP Health Care-UVM Health Network health plan will
focus equally on wellness and sickness.
Emphasizing preventive care services can be a key marker of
a wellness-centered health plan.
Payers can affect that change from being
driven by illness to being driven by wellness through individual- and
community-level interventions. Those interventions can range from screening
events that are available to the entire community to personalized technologies
that offer targeted solutions.
The plan will also seek to control healthcare spending. The
press release indicated that the health insurer and academic health system will
leverage value-based care frameworks such as the All Payer Model in Vermont or
the payment reform initiatives in New York.
Preventive care is a value-based care strategy that payers
often utilized to reduce healthcare spending.
By taking steps to lower members’ risk of developing chronic
conditions and by catching diseases early, health plans diminish the likelihood
of members having to undergo high-cost procedures. Even for the most expensive conditions in the
US—including heart disease, stroke, cancer, and diabetes—payers can lower costs
through screenings and wellness programming.
During the coronavirus pandemic, payers turned to in-home screening kits to
continue supporting their members’ preventive care needs.
Another potential wellness-centered strategy is wellness
programming.
Experts’ opinions are mixed as to whether or not wellness
programming is effective at reducing healthcare spending. Most recently,
researchers found that a wellness program that
focused on helping members lose weight could save the nation $8 billion over
the course of three years, if one out of every six obese patients joined the
program.
But other data demonstrates that wellness programs face
challenges that prevent members from experiencing positive results. Long-term commitment to the wellness
program and company culture can be influential
factors that may determine whether members achieve their goals and, ultimately,
reduce the plan’s healthcare spending.
In addition to focusing on pursuing wellness and reducing
healthcare costs, the new Medicare Advantage plan will be provider-driven. The
partners put a strong emphasis on the fact that local providers would be
integral to their approach.
“We realize our patients have choices when it comes to
Medicare Advantage plans. Our intent is to give them a better option that is
tailored to their health care needs by offering a unique plan shaped by our
experienced, local providers,” said John R. Brumsted, MD, president and chief
executive officer of UVM Health Network.
“By reinforcing vital provider relationships, focusing on
improving the lives of people in our communities, and leaning on the
patient-centered missions of our two organizations, we will make health
insurance more convenient, more supportive and more personal,” agreed Del
Vecchio.
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