Solution Focused Contracting with Employers

Recently I had the privilege of sharing an important webinar with Southern New England Healthcare Organization (SoNE HEALTH) on their amazing leadership efforts to contract directly with employers. I was joined by an impressive leadership team: Lisa Trumble, President & CEO; Michael McHale, COO; and John Sunde, VP Payor Strategies, as well as their partner, Laurel Pickering, Head, Strategic Alliances at Centivo.

SoNE HEALTH is a clinically integrated network focused on population health – as a collaboration between physicians and the hospital partners of Trinity Health Of New England, SoNE HEALTH is comprised of 1,600+ primary and specialty care physicians, six hospitals and nearly 200,000 covered patient lives across Connecticut and Massachusetts.

The healthcare market where SoNE HEALTH operates (MA and CT) has been dominated by national payers for decades. While these payers can carry considerable clout with brokers, employers, and purchasers, the consistently rising costs combined with increased interest in consumer-oriented health and wellness benefits have shifted the market’s inclinations. SoNE HEALTH leaders realized they could cut out the traditional intermediary to directly deliver a value proposition to employers and consumers. Coupled with the support of some key brokers, consultants, and providers seeking to drive value-based healthcare, they initiated a careful strategy to flip the paradigm and broaden their portfolio of value-based contracts to include direct-to-employer solutions, starting in mid-2020.

To launch their efforts, leaders at SoNE HEALTH partnered with Centivo, “an alternative to traditional insurance carriers,” that offers technology, claims processing, and customer support services while supplementing the population health management programs available through SoNE HEALTH. With a flexible partnership, SoNE HEALTH and Centivo can customize their collaboration to meet a variety of employer needs – ranging from smaller and mid-sized employers who are more willing to move into direct contracts sooner, up to and including the large employers who are traditionally more likely to be stuck in the status quo.

The early results for delivering value directly to employers and employees are impressive:

  • A 35 percent decrease in annual costs for one employer partner
  • A 24 percent increase in PCP visits
  • Up to a 38 percent reduction in Urgent Care/ED visits and inpatient admissions
  • And more!

We published a Case Study Brief with SoNE HEALTH that offers more insights and also recorded the conversation – both of these resources are available to Institute members (and individuals who work at provider organizations can sign up for a free trial membership!).

I’m grateful for brave leaders like SoNE HEALTH who are actively pushing to lower costs and improve outcomes and care for their patients. Thank you, Lisa and team, keep up the great work!

Warm regards,
Daniel Chipping
Director of Operations, Institute for Advancing Health Value