Becker's Healthcare December 31, 2024
The relationship between health systems and payers has strained as inflation grows faster than reimbursement rates. Some health systems cut ties with certain payers amid contentious negotiations while others dropped Medicare Advantage plans. WVU Medicine took a different approach.
About 18 months ago, the 24-hospital academic health system launched its own health plan for more control over coverage. The health system had tried population health and risk-bearing programs in the past, but weren’t able to yield long lasting results.
“It works until it doesn’t,” said Nick Barcellona, CFO of WVU Medicine, during an interview with the “Becker’s Healthcare Podcast” at the CEO+CFO Roundtable in November. The conversation was supported by R1.
In the typical cycle with health plans, the system...
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