Health Reform Law Makes Us Relevant

John Marcille

For years, we sometimes felt as if we spent our days trafficking in a dead language. We threw terms around such as accountable care organizations, pay for performance, meaningful use, and bundled payments. Now, as Managing Editor Frank Diamond’s cover story on page 14 points out, those phrases may soon become common rhetorical currency.

“What this means is that the cost-containment initiatives that most insurers have been conducting for years under the radar have become mainstream,” consultant Michael Millenson told us when we explored the opportunities that the health reform law presents to insurers. And Jeffrey Kang, MD, MPH, Cigna’s chief medical officer, makes much the same point in my conversation with him on page 40. He adds that there will be parallel efforts to improve quality.

Health reform also means a fresh emphasis on primary care, a chance to “create a new network strategy,” in the words of another consultant, Linda Havlin of Mercer.

As we were going to press, a story broke that the Philadelphia region’s largest health plan, Independence Blue Cross, will launch a pay-for-performance model that could, for instance, reward a doctor treating 850 Independence patients an extra $150,000 a year for a job well done.

But get this line from the story in the Philadelphia Inquirer: “A key element of the program rewards doctors who meet standards as so-called patient-centered medical homes. Such practices offer greater access for patients, follow treatment guidelines, educate people to better manage their own health, and prescribe drugs by computer.” You don’t say? Look at MANAGED CARE’S Web site and you’ll find that we’ve been reporting on “so-called” medical homes for years. We can’t wait for how the consumer press covers the launch of the ICD-10 code set. We always knew that if we were patient enough, the rest of the world would eventually catch up.