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News From the ACO Frontier

Tennesee's Saint Thomas Health is projecting a January launch for MissionPoint Health Partners, an ACO-qualified organization but one with bigger aspirations and a smart partnering strategy. From The Tennessean:

"The partners include Saint Thomas Health’s five hospitals and 200 affiliated physicians, Cisco Systems, The Advisory Board Co.’s Crimson Services initiative, Applied Health Analytics and the YMCA of Middle Tennessee.
"MissonPoint is using a telemedicine platform from computer networking giant Cisco to improve access to medical specialists for rural, underserved communities. It plans to expand use of the high-definition video system to two other Middle Tennessee communities and add new specialties such as dermatology and psychiatry.

"Nashville-based Applied Health Analytics’ part of the mission is to help pinpoint health risks within populations of employees and recommend ways to address those problems, which could include a high rate of obesity, for example.

"In some cases, employees could receive a coupon to help cover the cost of membership in the local YMCA. The YMCA would also offer fitness programs and other services, including those for people recovering from breast cancer."
[Read more...]

And in this interview with Kaiser Health News, Bruce Bodaken, CEO of Blue Shield of California discusses one of his favorite subjects: the "accountable care organization" that Blue Shield is partnering with CalPERS, which administers pension funds and health care benefits for public employees.

"In Sacramento, in our ACO partnership with CalPERS, we've seen a 15 percent reduction in hospital readmissions, and a reduction in admissions as well. We committed to CalPERS that we would seek a zero percent trend. They received a zero premium increase for 41,500 members in the ACO; their premium was the same in 2009 as in 2010. We did it by becoming more efficient, so it's not a function of losing money. Blue Shield, Catholic Healthcare West and Hill Physicians agreed to share the risk to deliver promised savings, and all of us were able to achieve a modest bottom line."
I took some heat from my hospital colleagues a while back over my less-than-technical reading of the ACO regs.  Apparently my forecast that dithering hospitals would soon find ACO competition coming from untraditional and unexpected sources - insurance companies, pharmacies, etc. - conflicted with their beliefs that forming an ACO is an activity explicitly reserved for hospitals and physicians.

Well, well.

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