OSF plans for value-based care in Medicaid

The majority (70%) of OSF HealthCare’s business is paid for by Medicare and Medicaid, prompting Mike Allen, FHFMA, MBA, the system’s CFO, to identify Medicaid as presenting the next big opportunity for assuming risk under a value-based care approach. 

“Trying to wade into a value-based agreement for the Medicaid population is not for the faint of heart, but we’re cautiously watching for the opportunity to do that,” Allen said. To prepare, OSF contracted with the state of Illinois to provide virtual pre- and post-partum services to obstetric patients covered by Medicaid. 

It is not an insurance contract, but a services contract for patients living in a certain part of the state. In its efforts to engage patients who might not otherwise be able to access appropriate care, OSF works to help mothers avoid potentially devastating — and expensive — problems for themselves and their babies. 

OSF already convened the Medicaid Innovation Collaborative (MIC), a partnership between OSF and four federally qualified health centers. The state-funded, five-year initiative is designed to improve outcomes, decrease disparities and reduce costs using sustainable programs, according to OSF.

“As we learn more about how to deliver those kinds of services and prove we can reduce the cost of care for those services, that gives us the opportunity to consider Medicaid as a potential value-based payer,” Allen said.