How Morgan Health is Paving the Way for Advanced Primary Care

Advanced primary care tied to a person-level payment model is key to improving outcomes and reducing costs, at least according to the Duke Margolis Center for Health Policy and Morgan Health, a new business unit from JPMorgan Chase focused on improving employer-sponsored healthcare.

Employer-sponsored healthcare is the primary source of coverage for Americans today. Yet, the private sector faces many challenges with getting this population high-quality, affordable care, the two organizations explain in a new report.

“Employers can improve [healthcare] access and outcomes, increase equity, and reduce total costs by implementing a strategy that uses advanced primary care to enable comprehensive, coordinated care for employees and their families,” the report states.

Advanced primary care combines a range of capabilities, such as advanced data analytics, home-based care, virtual care, care coordination, and team-based care, to improve patient outcomes and reduce total cost of care. Importantly, the care model also relies on a per-person payment over the traditional fee-for-service payment structure to fund the capabilities and achieve desired outcomes.

Fee-for-service is a “key reason” why employer-sponsored healthcare has “poor coordination, insufficient support for staying well, inconvenient access, and lack of transparency about quality and cost,” the report states.

Meanwhile, person-level per-member per-month payments and direct contracting have proven to finance care models that incent preventative, accessible care that is affordable, especially for public payers and their beneficiaries.

Morgan Health is looking to bring those care improvements to employer-sponsored healthcare starting with JPMorgan Chase employees in the Columbus, Ohio area.

“When you look at the discourse around what's happening right now, you see a lot more focus on Medicare, Medicaid, the exchanges, and the like, and it's understandable why. But we really need to focus on this part of America's healthcare system in order to achieve the objectives that all of us have been talking about for so long, including accountable care,” Dan Mendelson, CEO of Morgan Health, explained in a webinar hosted by the Duke Margolis Center for Health Policy yesterday.

Morgan Health has only been around for about four months, but the new business unit has already partnered with Vera Whole Health, a company that contracts directly with employers to implement advanced primary care. To start, the companies are bringing advanced primary care to employees through independent primary care practices like Central Ohio Primary Care, which treats about a quarter of JPMorgan Chase’s employees in that area.

“We are going into this with a belief that having a really strong primary care connection point and a leveraging a primary care model where it's not just a primary care physician, it's a team-based approach that also deploys technology, has tremendous potential. We believe in its potential in Medicare, and we believe in its potential in the private sector,” Mendelson stated.

The primary care practices partnering with Morgan Health will be held accountable for total cost of care for the assigned population through capitated payments, the report elaborates. Morgan Health believes the person-level payment structure will support those enhanced capabilities under an advanced primary care model, which fee-for-service doesn’t typically pay for, while also funding more long-term and infrastructure investments for comprehensive care.

“We're going to get the incentives lined up right and make sure that there are financial incentives to accomplish all the objectives that we set out,” Mendelson explained in the webinar. “It's not only quality. It will also be health equity.”

Promoting health equity is one of Morgan Chase’s three focus areas, with the others being health system improvement through a $250 million capital allocation and enhancement of JPMorgan Chase employee health benefits. Health disparities not only impact the company’s employees but also the communities it serves. Additionally, these gaps in care can limit quality of care and health improvement gains, the company explains.

Delivering the right incentives for providers and self-funded employers is key to closing the gap across diverse populations, Mendelson emphasized. “We believe that by setting up strong incentives to achieve health equity that we can get more focused on it and least partway towards that objective.”

Morgan Chase’s journey into advanced primary care is just starting with Central Ohio Primary Care and only time will tell what improvements the alternative payment and care delivery model can deliver the employer. After all, similar endeavors have come and gone, especially in the public sector, and some with only modest improvements. However, Morgan Chase is taking the risk now to pave the way for high-quality, affordable for working folks.

“There is a growing level of frustration by American employers at rising costs and lack of accountability for outcomes and the events of the last couple of years, as cognizance of racial disparities has increased, has only exacerbated that frustration,” Mendelson stated. “To think that that you, as an employer, are part of a system that results in substandard care for groups of your employee base is not only frustrating, it is completely unacceptable.”

Unfortunately, there are just not many accountable care options for employers and their workers in most communities, Mendelson continued. “What we're doing is really an effort to create optionality for employers that want to do something different from the standard model.”