Walmart Bundles Payment For Employee Healthcare
By Dr. James Palermo // October 14, 2012
Large employers across the country are considering new models of healthcare and coverage for their employees with a focus on improving the value of healthcare across a continuum that offers better cost control and quality of care.
Walmart On The Forefront Of Innovative Healthcare Delivery
Walmart, the world’s largest retailer and the single biggest U.S. employer outside of the federal government, with about 1.4 million workers, is again on the forefront of innovative approaches to meeting the healthcare needs of their work force with a recently announced program that features bundled payment to providers at six selected U.S. “Centers of Excellence” for cardiac and spine surgery.
Beginning in January 2013 employees and dependents enrolled in the company’s health plan will have access to consultations and care for certain cardiac and spine procedures at no additional cost to them. Walmart will also cover the cost of travel, lodging, and food for the patient and one caregiver.
Selected ‘Centers of Excellence’ To Provide Bundled Care
The “Centers of Excellence” are some of the most highly respected organizations in the country related to the effectiveness and efficiency of care delivery and include: Cleveland Clinic in Cleveland, Ohio; Geisinger Medical Center in Danville, Pennsylvania; Mayo Clinic sites in Minnesota, Arizona and Florida; Mercy Hospital Springfield in Springfield, Missouri; Scott & White Memorial Hospital in Temple, Texas; and Virginia Mason Medical Center in Seattle, Washington.
“Healthcare is in the midst of an unprecedented transformation and requires innovation to improve the way we deliver care to patients across the United States,” said Cleveland Clinic President and Chief Executive Officer, Toby M. Cosgrove, M.D. “Programs such as these will help get patients to the right place, for the right care, at the right time while focusing on quality outcomes and cost control.”
Expansion Of Walmart and Mayo Clinic Partnership
The closest and most convenient “Center of Excellence” for employees of the ten Walmart stores in Brevard County in need of the costly and complicated cardiac and spine surgery is, of course, Mayo Clinic Jacksonville. The program expands the company’s partnership with the Mayo Clinic for transplant surgeries that launched in 1996 and will make Wal-Mart the first retailer to offer a national program that covers heart, spine, and transplant procedures.
“While reviewing associates’ medical experience with Mayo Clinic, benefits executives from Walmart discovered that Mayo physicians often found other cost effective ways to treat patients, such as medications, before pursuing transplant options,” said John Noseworthy, M.D., Mayo Clinic president and CEO, Mayo Clinic.
“Our partnership with Walmart remains strong today, and the company continues to recognize the value and quality of Mayo Clinic care. We’re proud to see that value is being recognized and that the approach is being expanded to include other providers who share the same philosophy.”
Bundled Payment Concept Offers Cost Control and Quality Improvement
The concept of bundled payments has been endorsed across the healthcare industry as a more effective and efficient way to compensate healthcare providers and enhance the overall delivered value by controlling costs and ensuring quality outcomes.
Bundling links payments for multiple services patients receive during an episode of care. For example, instead of a surgical procedure generating multiple claims from multiple providers for a diversity of services under the existing fee-for-service model, the entire team is compensated with a single “bundled” payment that provides incentives to deliver health care services more efficiently while maintaining or improving quality of care.
Walmart’s deals with the six “Centers of Excellence” could have a ripple effect and may be copied by other companies looking to control medical spending and establish a better value proposition for patients, providers and payers.