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Patient Choice is a nationally recognized leader in developing health care programs that enable value-based purchasing. Our innovative programs feature provider networks that are tiered based on measures of cost and quality. Consumers have access to comparative information so they can easily identify better performing providers.
The approach fosters competition by measuring the variations that exist in provider performance and sharing that information with the purchasers of care—namely employers and consumers. The result is a consumer-friendly health care marketplace that:
- allows providers to be accountable to their patients for their care delivery results and recognizes and rewards those who deliver quality care.
- gives employers the ability to use their purchasing dollars to obtain greater value, without limiting consumer choice.
- educates consumers to be better managers of their care and empowers them to make value-based choices.
Providers — respond to consumers with purchasing power by improving efficiencies, introducing quality improvement initiatives and in some cases, dramatically lowering prices to be competitive.
Employers - benefit from greater cost savings as employees—armed with comparative provider data and education on incentives—migrate to providers who deliver quality care at a lower cost.
Consumers - gauge value using both cost and quality information and choose providers that best meet their unique needs.
Innovative Programs
Patient Choice currently serves self-funded employers in Minnesota, South Dakota and limited areas of North Dakota and western Wisconsin. Our innovative program offerings include:
- Patient Choice Care System Program
The Patient Choice Care System program features a network that tiers groups of health care providers and facilities called “Care Systems." These Care Systems are analyzed on measures of cost and quality and placed into three tiers.
Employers offer a choice of Care Systems, giving employees the option to contribute less toward their premium when selecting lower cost Care Systems. Employees review comparative information about Care System performance to help guide their choices. Once enrolled, employees obtain care from providers affiliated with their selected Care System.
- Patient Choice Insights
Patient Choice Insights is a new program dedicated to helping employers manage their health care costs and to offering employees freedom of choice, while assisting individuals in becoming better health care consumers.
Patient Choice Insights uses an approach whereby individual health care providers and facilities are tiered according to cost and quality factors and employees are rewarded for using more efficient, high quality providers. Employees can access any provider in the network—in any tier, at any time. Comparative data enables employees to “comparison-shop” based on their personal situation or a specific condition.
Results
The Patient Choice program is nationally recognized as an innovative, leading-edge approach to health care purchasing. Our approach has been studied by numerous organizations including Harvard Business School and the University of Minnesota and has received media attention from a variety of prestigious business and industry publications.
Since 1997, the program has been successfully delivering results to Minnesota employers. In each year of operation, employer participants have benefited from lower overall medical costs and administrative fees when compared to market alternatives.
The program has also shown that:
- Consumers with access to cost and quality information will migrate to better performing, lower cost providers
- Providers respond to consumer who are able to “comparison shop” by holding down costs and/or improving efficiency
- Employers experience reduced trends and administrative fees, while driving improvements quality of health care service delivery
- Improved quality through increased use of best practices, lowers total cost
Background
In 1997, the Buyers Healthcare Action Group (BHCAG), a prestigious group of Minnesota
business leaders, frustrated by escalating health care prices and the lack of
focus on quality, launched Choice Plus, the first tiered health care delivery
network in the country.
Patient Choice Healthcare Inc., was formed in 2000 to assume management of the Choice Plus program (now know as the Patient Choice Care System Program) and to build on its success by creating programs that spur greater competition in the health care market, control costs, improve quality and enhance consumer choice.
Having admired Patient Choice for its nationally recognized innovations in consumer-driven health care and provider incentives to improve quality in health care, Medica acquired the Minnesota and Dakota operations of Patient Choice* in the spring of 2004.
Today, the Patient Choice program is the longest running most well established of its kind. Operating as a business segment within Medica, Patient Choice continues to develop programs that lead the market toward value-based health care purchasing—differentiating provider performance and giving consumers the information they need to evaluate cost and quality.
Patient Choice programs are available to self-funded employers of all sizes in Minnesota and the Dakotas.
*The consulting division of Patient Choice Healthcare continues to serve clients across the country and operates independently from Medica.
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