Blue Shield of California, Greater Newport Physicians Medical Group and Hoag Memorial Hospital Presbyterian to Join Forces on Coordinated Care Model [Professional Services Close – Up]

Blue Shield of California, Greater Newport Physicians, IPA and Hoag Memorial Hospital Presbyterian announced a three-year accountable care initiative designed to provide integrated, cost- efficient health care to approximately 11,000 Blue Shield HMO members in Orange County.

The partners noted they expect this collaboration to result in little to no increase in healthcare costs for these members in the first year of the collaboration, and low single digit increases in the two subsequent years.

To achieve this goal, the organizations will identify and implement long-term strategies aimed at improving quality and efficiency to ensure that health care stays affordable for Blue Shield members. The healthcare entities will work together to share clinical and case management information and to coordinate healthcare services. The organizations' incentives will be aligned to improve healthcare quality and patient service while reducing costs.

This initiative launches July 1, and will continue for a minimum of 36 months. It is the parties' collective intent to extend the collaboration even longer in order to have a material, sustainable impact on healthcare costs for members and employers over time. The goal is to build a care delivery model that improves quality through better coordination of care while taking costs out of the healthcare delivery system. Preliminary work is already underway across the three organizations, and will accelerate in the coming months.

"Greater Newport Physicians has always been a leader in adapting to the dynamic healthcare environment to better serve the needs of our patient population," said Cassidy Tsay, M.D., M.B.A., Medical Director of Greater Newport Physicians. "We coordinate the care of our patients as they navigate throughout the entire health care system, because we know that patient care includes prevention, chronic care management, acute episodes of care and post- hospitalization recovery. We look forward to sharing this philosophy with our partners."

"We are pleased to collaborate with Greater Newport Physicians and Blue Shield of California to provide affordable health care for the community and employers in Orange County and, in turn, ensure they have access to the personalized care they expect from Hoag," said Richard Afable, M.D., Hoag President and CEO. "This collaboration allows us to continue to provide the highest quality care to the communities we serve, as one of Orange County's most trusted healthcare networks."

The collaboration with Greater Newport Physicians and Hoag, which is subject to the approval of the California Department of Managed Health Care, is Blue Shield's sixth commercial accountable care organization. Blue Shield currently works with hospitals, physician groups and employers on ACOs to deliver integrated care to 100,000 Californians in Sacramento, San Francisco, the Central Valley and Orange County.

"This collaboration with Greater Newport Physicians and Hoag is aimed at delivering high-quality coordinated care to Blue Shield members in Orange County. It's another milestone in our ongoing effort to transform how we provide and pay for care to make health coverage more affordable to all Californians," said Juan Davila, senior vice president of network management for Blue Shield of California.

Blue Shield of California:

blueshieldca.com

Greater Newport Physicians:

gnpweb.com

Hoag Memorial Hospital Presbyterian:

hoag.org

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