Blues plans launch new ACOs in Tennessee, California


Two Blue Cross Blue Shield plans announced Wednesday they will launch new accountable care organizations (ACO) in Tennessee and California.

Blue Cross Blue Shield of Tennessee is partnering with Memphis-based Methodist Le Bonheur Healthcare in the city's first such arrangement. Beginning Jan. 1, both Blue Cross and Methodist will be held financially responsible for performance-based measures aimed at ensuring quality care while cutting costs. Blue Cross will pay doctors based on their ability to meet those outcomes, instead of the amount of services they provide to patients, the Memphis Commercial Appeal reported.

"Methodist demonstrated that they are ready to approach care in a completely different way and partner with us to focus on quality and patient outcomes," Bill Gracey, CEO-elect for Blue Cross, said in a statement last week.  "This adds the extended, long-term benefit of making us more competitive in the market, which translates to cost savings for our customers."

The terms of the Blue Cross-Methodist ACO also include Methodist replacing the Baptist Memorial Health Care system as Blue Cross's Network S provider, a lower-cost, quality-focused provider network, reported the Memphis Business Journal.

Meanwhile, Blue Shield of California has teamed up with Dominican Hospital and Physicians Medical Group of Santa Cruz County in a three-year ACO that will provide cost-efficient care for about 8,000 of its HMO members. Blue Shield and the providers will coordinate clinical and case management information to coordinate a comprehensive approach to healthcare.

"This collaboration with Dominican Hospital and PMG is aimed at delivering high-quality coordinated care to Blue Shield members in Santa Cruz County," Juan Davila, Blue Shield's senior vice president of network management, said in a statement. 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."

To learn more:
- read the Memphis Commercial Appeal article
- see the Memphis Business Journal article
- check out the Blue Cross statement
- read the Blue Shield statement

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