ACO success leads to new insurance products


As accountable care organizations (ACO) become more popular and successful, insurers have started launching new products wrapped around the ACO model to further cut costs and recruit new members, reported AIS Health.

"All health plans are looking for ways to align provider networks with themselves," John Nimsky, vice president of network strategy at Gorman Health Group, told AIS Health. "The old days of contracting only and devising reimbursement rates--those days are rapidly drawing to a close." Now, payers and providers must collaborate to lower costs and improve quality, he added.

For example, both Aetna and Anthem Blue Cross and Blue Shield have partnered with Wisconsin provider Aurora Health Care to create new health plans in conjunction with ACOs. Aetna and Aurora formed the Aurora Accountable Care Network, a first-of-its-kind insurance product that offers price guarantees to employers and limits members' premium increases, FierceHealthPayer previously reported.

About a month later, Anthem reached a deal with Aurora to launch the Blue Priority health plan, which Anthem President Larry Schreiber said is an example of "where the industry is moving." Blue Priority links provider competition with risk and information sharing, as well as care coordination and outcomes, he added.

Since Aurora controls almost 60 percent of Wisconsin's provider service area, Schreiber said it was a logical provider to partner with. "It was much easier than dealing with multiple systems [to cover the same ground]. ... There will be better collaboration of care, feeding data through a single organization and sharing the dataset," he said.

What makes the Blue Priority plan different, Schreiber said, is its ability to let employers "layer on" levels of efficiencies in the future.

To learn more:
- read the AIS Health article

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