Worcester Business Journal

wbjournal.com | February 20, 2017 | Worcester Business Journal 11 care in a much better way, in a much more prudent way," Muldoon said, adding UMass Memorial Health Care's plans to submit an application for the pilot were imminent. Resowing the seeds of trust The managed care model was tested in the 1980s and 1990s and eventually failed. There was an overall feeling of distrust of the system by consumers, with a lack of provider choice and a fear the health management organiza- tions would skimp on needed services to save money. Proponents of the ACO model have pointed to its emphasis on quality outcomes being tied to pay- ment as a safeguard. Managed care contracts still exist on a smaller scale in today's health insur- ance market, and with government incentives encouraging the adoption of ACO models, they are poised to once again become more popular under the ongoing shift away from fee-for-service insurance reimbursement, and toward risk-based contracts. Thomas Ebert, chief medical officer at Worcester-based Fallon Health, said moving MassHealth patients to ACO contracts may limit their choices somewhat, but organizing the popula- tion within networks is necessary. Like UMass Memorial, Fallon is also planning to participate in the MassHealth ACO pilot. "At the end of the day, having provid- ers and plans working together … will help manage the care for higher quality care, for less money," Ebert said. Health insurance is a non-required employee benefit Gov. Charlie Baker has proposed fining Massachusetts companies with more than 10 workers a $2,000 penalty per full-time employee if they do not offer a qualifying health plan to those workers, using the estimated $300 million in revenue from penalties to offset the estimated $600 million in increased Medicaid costs for fiscal 2018. When polled, WBJ readers said businesses should not be forced to carry health insurance for workers. F L A S H P O L L Should companies be fined for not offering health insurance? 15% Yes. Uninsured workers create an unnecessary strain on Medicaid. Yes. The cost of health care is a universal issue and businesses need to contribute. 28% No. Health insurance is an employee benefit and employers should not be forced to offer it. 49% 8% No. The government should offer universal health care and relieve businesses of the burden of offering it to workers. Gabriel Luna performs an eye exam at the UMass Memorial Eye Center in Worcester. The Massachusetts ACO pilot seeks to have providers and insurers lower healthcare costs by providing for the health of entire populations through measures like preventative care. W P H O T O / C O U R T E S Y

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