New Insurer-Hospital ACO Touts Early Success

By Mike Segal

In late 2010 Advocate Health Care, the largest hospital system in Illinois and a pioneer in accountable care, and Blue Cross and Blue Shield of Illinois, the State’s largest managed care company, entered into a three year agreement beginning in 2011, in which rates in providing care to more than 200,000 BCBS enrollees were to be tied to performance targets geared to improved quality, safety and efficiencies of medical care provided to BCBS patients, with shared savings included. Advocate gambled that its share of the savings would compensate for its lost hospital revenues.

So, how is it going? Well, in a recent article, the parties report that the initial data is encouraging, although not yet conclusive. “It’s clear we’re driving down utilization,” said Lois Elia, an Advocate Vice-President. One of the keys to the results is said to be the hiring of 60 case managers, many embedded in physician practices (Advocate has a network of approximately 4000 physicians), to manage high-risk cases and post-acute care.

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