Independence Blue Cross Announces Results of its Accountable Care Organization (ACO) Payment Model
Targeted News Service |
Rewarding physicians and hospitals for collaborating to improve quality of care and lower costs is making a measureable difference in the
"We're very encouraged by these results," said
Accountable Care Organizations are groups of doctors, hospitals, and other health care providers that come together to provide coordinated high quality care to their patients. The Independence accountable care payment model requires health care providers, often a hospital and its affiliated primary care physicians and specialists, to establish an ACO-like entity that shares responsibility with the insurer for improving clinical performance and cost efficiency for the care delivered to patients.
Key results from hospitals and health system participants in the first year include:
Half of the hospitals participating successfully reduced their medical costs, determined by customized targets based on historical costs;
Nearly 90 percent of the participants lowered hospital readmission rates with an average reduction of 16 percent;
100 percent of the health systems improved at least one hospital-acquired infection measure or received a top distinction from the
Nearly all participants scored better in measures that assess patients' experience during their hospital stay, such as their understanding of information about recovery at home.
"It's extraordinary to have such a high rate of engagement in our innovative ACO payment model, which reflects the true partnership we've built with hospitals and health systems," said
The potential performance-based incentive dollars for doctors and hospitals is expected to approach
"The financial incentives Aria receives through Independence's accountable care payment model have helped us foster greater alignment and collaboration among patients, physicians and hospitals," said
Under the Independence accountable care payment model, half of the potential earnings for the hospital and physicians are based on their ability to improve their performance related to hospital acquired infections, patient experience, readmissions, and surgical care, and the treatment of heart attacks, heart failure, and pneumonia. The other half of the potential incentive payment is based on their ability to manage costs through greater collaboration and coordination of inpatient, outpatient, ancillary care, home health, prescriptions, and other health services.
"This program is an important step in improving health care in America by focusing on value, not volume," said
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