BCH, Cigna try ‘pay for value’ to cut costs

You may have noticed that many hospitals and health-care providers are looking for more ways to keep patients healthy and to lower medical costs.

A new collaboration between Boulder Community Hospital and Cigna Corp. (NYSE: CI) insurance company is a good example.
Cigna plans to pay doctors a set amount every month for each member insurance patient, according to Vroom. Without giving financial details, Vroom said the amounts paid will vary among doctors who see Cigna patients, depending on location and by practice.

Cigna’s goal with the Boulder Community Hospital program is to create something that works similar to the Accountable Care Organizations that are coming online as part of the federal Affordable Care Act going into effect in January, Vroom said. The Affordable Care Act, now commonly called “Obamacare,” was passed by Congress in 2010.

Accountable Care Organizations are the result of a provision in the Affordable Care Act that allows the federal Medicare program to reward doctors and hospitals who save money on Medicare patient treatment.

The new “pay for value” structure for the hospital/Cigna collaboration is very different from the old model of how insurance companies paid for health-care services, Vroom said. Under the old model, doctors would be paid for the number of services they provide.

Strong marks for area hospitals

We also want to give Boulder Community Hospital a shoutout for receiving an “A” grade in a recent national safety survey by The Leapfrog Group, a self-described independent industry watchdog.

The rating indicates how well hospitals protect patients from accidents, errors, injuries and infections, according to Washington, D.C.-based Leapfrog, which was created in 1998 by member employer hospitals and other health-care providers. Hospitals are surveyed and rated for free but must pay a licensing fee if they want to advertise their scores or use a related safety logo.

Boulder Community Hospital does not plan to pay to license the logo or to advertise the score, according to Rich Sheehan, a hospital spokesman.

The rating uses 28 measures of publicly available hospital safety data to come up with a grade of “A,” “B,” “C,” “D” or “F.” More than 2,500 hospitals in the United States were assigned scores by The Leapfrog Group this fall.

Avista Adventist Hospital in Louisville also received an “A” in the national safety survey. Longmont United Hospital in Longmont and Exempla Good Samaritan Medical Center in Lafayette both received a “C” in the survey.

No Longmont United Hospital representative was immediately available for comment about the ratings. Exempla spokeswoman Mary Meeks pointed out that the hospital received an “A” grade the last time a Leapfrog Group rating was compiled about a year ago. Meeks also said different groups gather and report hospital safety information in different ways, creating results that “can be inconsistent and therefore confusing to all of us.”

Exempla has received awards recently from other rating groups – most notably two commendations related to heart failure and stroke from U.S. News & World Report magazine in October and other recent mentions from the American Heart Association, Meeks said.

Alzheimer’s to insulin

Biopharmaceutical research company AmideBio LLC has named a biotech veteran to its business advisory board as the company starts to research a form of insulin that would not need refrigeration.

AmideBio made its name as a company that created a product that could be used by Alzheimer’s researchers. The company plans to use its existing manufacturing processes to make the new form of insulin, according to a press statement.

David Bradbury, the new business advisory board member, formerly was president and chief executive of Amylin Pharmaceuticals Inc. (Nasdaq: AMLN) in San Diego, a diabetes drug and research company. Amylin was bought by a subsidiary of pharmaceutical company Bristol-Myers Squibb (NYSE: BMY) in 2012 for an estimated $5.3 billion.

AmideBio hopes to use Bradbury’s expertise to help build its own research as well as to “cultivate new relationships with pharma partners,´ said Misha Plam, the company’s president and chief executive.

Beth Potter can be reached at 303-630-1944 or bpotter@bcbr.com.

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