Blue Shield of California announced plans to link up with Dominican Hospital, Santa Cruz, Calif. and Physicians Medical Group of Santa Cruz County, to form an accountable care organization (ACO). It is the insurer's eighth ACO.
ACOs, a linchpin of the health reform act, combine hospitals, primary care doctors and specialists to provide integrated care delivery to a defined group of patients, usually within a state, and is accountable for Medicare and Medicaid spending and quality of care for patients in that population.
According to a story by Melanie Evans, the agreement will try to hold healthcare costs to a minimum increase for enrollees during the first year, according to a news release announcing the deal, which will cover about 8,000 managed-care enrollees and last at least 36 months.
Costs will rise with percentage increases in the low single digits for the second and third years, Evans reported.Dominican Hospital, sponsored by Dignity Health, formerly Catholic Healthcare West, entered into an accountable care contract earlier this month with Blue Shield of California.
“The healthcare entities will work together to share clinical and case management information and to coordinate comprehensive healthcare services,” according to a recent statement. “The organizations' incentives will be aligned to improve healthcare quality and patient service while reducing costs.”“We are proud to participate in this collaboration as we believe it is an important step in modernizing the healthcare system so that we can deliver better care at an affordable price,” said Dr. Nan Mickiewicz, president of Dominican Hospital.
According to Crain’s New York Business, a survey of 45 hospitals in New York, New Jersey and Connecticut are still in just the beginning stages of exploring whether to establish accountable care organizations.
As for the rest of the country, Michael L. Millenson wrote at Kaiser Health News that ACOs could have “the Medicare muscle to transform the health system.”
And they could, with their formula to end payments to doctors in lump sums, replace them with spending and quality of care measurements to qualify for federal reimbursement.
Edited by
Braden Becker
