Independence Blue Cross touts positive results from ACO payment model

Screen-Shot-2013-01-07-at-2.36.40-PMIndependence Blue Cross, the Philadelphia region’s largest health insurer, said Monday its accountable-care organization payment model is yielding tangible results.

According to IBC, about 90 percent of region’s health care delivery systems are participating in the ACO payment model. Results from the first year include:

  • Nearly 90 percent of the health systems 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 Pennsylvania Department of Health for infection control;
  • 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;
  • Half of the hospitals participating reduced medical costs, determined by customized targets based on historical costs.

Accountable Care Organizations are typically groups of doctors, hospitals, and other health-care providers that work together to provide coordinated quality care to patients. The IBC accountable care payment model requires health-care providers, typically a hospital and its affiliated primary-care doctors 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.

The potential performance-based incentive dollars for doctors and hospitals is expected to approach $150 million in 2014, according to IBC.

“We’re very encouraged by these results,” said Daniel J. Hilferty, president and CEO of IBC. “They demonstrate the power of partnering with health care systems in our region to deliver higher quality, lower cost care with higher patient satisfaction.”