Detroit-based Henry Ford Health System has kicked off its first direct-to-employer healthcare contract with General Motors.
Under the contract, the system will provide care and wellness services to more than 24,000 salaried GM employees and their dependents. GM's "ConnectedCare" plan, which will offer access to more than 3,000 physicians from Henry Ford's network, begins open enrollment this fall.
Here, Bruce Muma, MD, CMO and interim president and CEO of Henry Ford Physician Network, discusses the reasoning behind the contract and what makes it unique.
Note: Responses have been lightly edited for length and clarity.
Question: What prompted the contract?
Bruce Muma: GM was the entity that decided to create this opportunity. They launched a request for proposal process last spring, so we were one of many participants in the process.
Q: What are the terms of the contract? How will it work?
BM: People refer to [the agreement] as a direct-to-employer contract if you're on the provider side, and if you're on the employer side, it's referred to as a direct-to-provider contract. It's essentially a contract between the employer and provider system to create new value for the employees and their dependents. The new value is really measured by the [healthcare] Triple Aim — improved service, improved quality and reduced costs. The request for proposal process and subsequent negotiation was structured around creating a shared savings model that is really driven by the achievement of the Triple Aim performance metrics. We are using Blue Cross Blue Shield as the third-party administrator to adjudicate the claims and manage the benefit interpretation implementation and work collaboratively with GM and Henry Ford. It's a three-way relationship to create new value.
Q: What is the goal with the contract?
BM: [The contract] really is to create new value for General Motors beneficiaries. It's not just to reduce costs, it's truly a value-based agreement. I always emphasize this is about experience as much as it is cost, and General Motors has made that clear from the very beginning.
Henry Ford Health System has always had a focus on value, but recently our strategic plan specifically reflects our desire to become the high-value provider in this market. So, this opportunity to prove that point or to demonstrate we are a high-value provider is very appealing to us. We'll have the chance to work with General Motors and to innovate and to learn how to become even more value-based and create higher-value healthcare.
Q: What are the next steps?
BM: Open enrollment will start in early October into early November. A lot of work right now is around communication, making sure everyone on the provider side understands what is expected of us starting on Jan. 1 [when coverage kicks in], [and] building new processes that will ensure we can meet those requirements.
[Next steps also involve] starting to build the pathways and venues for the new enrollees to connect with our health system and connect with our providers. We [want to] start off the beginning of the year with a collaborative and engaged relationship with all the beneficiaries and help them receive care that's higher value — help them understand how to use the product, how to connect with providers and have a better experience.
Q: What makes this arrangement unique?
BM: It's unique in that it's not really brokered through a health plan per se. There is a third-party administrator, but it's a direct-to-employer shared risk contract and there aren't a lot of those, especially of this magnitude.
Q: What will this contract look like moving forward?
BM: One of the core values we share with General Motors is innovation, and so this opportunity in some ways is kind of synergetic. General Motors is looking for innovation in healthcare to provide more value, and so are we. I think there are going to be a lot of opportunities over the course of the five years [of the contract] to look for unique and innovative approaches to delivering healthcare, particularly outside of the traditional healthcare setting.
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