Milwaukee-based Aurora Health Care has launched an accountable care organization (ACO) with Anthem Blue Cross and Blue Shield.
Known as Blue Priority, it’s designed for small- to medium-sized Wisconsin employers and self-insured organizations, according to an Anthem statement.
“Through Blue Priority, the two organizations will exchange clinical data, co-manage patient cases and establish quality benchmarks in order to enhance health outcomes while eliminating inefficiencies,” Anthem said.
Aurora's 14 hospitals and its network of clinics, physicians and surgery centers will offer care to members. Even if they’re not in the state at the time, members will still be able to get access to the Blue Cross network, a spokesman said.
The Blue Priority network will be available Nov. 1.
Not everyone is on board with ACOs. An issue brief by the Commonwealth Fund found that about 75 percent of hospitals said they were not exploring the model at all in last year, according to a story by Andis Robeznieks. But the brief also noted that as of this summer, 154 groups were participating in CMS-sponsored ACO initiatives, Robeznieks added, and “a recent report identified 221 ACOs in 45 states.”But doctors, who may not always make out the best with ACOs, were leading the charge for governance. That’s because the way ACOs are set up is no longer to pay doctors what they charge, but to determine, through quality of care and outcomes, what doctors will be paid.
The brief also noted that as of this summer, 154 groups were participating in CMS-sponsored ACO initiatives. A recent report, it added, identified 221 ACOs in 45 states.In February of 2011, nine-hospital Franciscan Alliance in Mishawaka, Ind. announced it was forming an ACO with Anthem Blue Cross and Blue Shield. And in August of that year, Anthem and the Individual Practice Association Medical Group of Santa Clara County, a San Mateo, Calif.-based medical group that includes more than 800 physicians, also launched an ACO.
Edited by
Braden Becker
