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Advocate-Blue Cross ACO Sees Improvement in Utilization, Costs
The state's largest health network and largest health insurer have shown marked reductions or slower growth in the use of services as part of their three-year-old accountable-care organization, an encouraging sign as providers and payers try to reduce the cost of care.
The state's largest health network and largest health insurer have shown marked reductions or slower growth in the use of services as part of their three-year-old accountable-care organization, an encouraging sign as providers and payers try to reduce the cost of care.
Advocate Health Care and Blue Cross & Blue Shield of Illinois started their ACO, called AdvocateCare, three years ago aiming to better align financial incentives between the two mammoth organizations. The utilization trends, which Blue Cross provided to Crain's, provide a glimpse into the progress of one of the country's first and largest commercial ACOs.
Similar to the Medicare accountable-care organizations established by President Barack Obama's health reform law, the Advocate-Blues venture pays doctors and hospitals based on how well they meet quality, patient satisfaction and cost metrics for a defined population of about 380,000 members, rather than the traditional fee-for-service model. The ACO does not include all Advocate patients covered by Blue Cross.
Read the full story here: http://bit.ly/1fbSbgK
Source: Chicago Healthcare Daily
Managed Care Reflections: A Q&A With Hoangmai H. Pham, MD, MPH
April 1st 2025To mark the 30th anniversary of The American Journal of Managed Care® (AJMC®), each issue in 2025 will include a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The April issue features a conversation with Hoangmai H. Pham, MD, MPH, a member of AJMC’s editorial board and the president and CEO of the Institute for Exceptional Care (IEC).
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Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
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Bridging Care Gaps With a Systemwide Value-Based Care Strategy
March 29th 2025Mapping care management needs by defining patient populations and then stratifying them according to risk and their needs can help to spur the transformation of a siloed health care system into an integrated system that is able to better provide holistic, value-based care despite the many transitions that continue among hospital, primary, specialty, and community care environments.
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