January 17, 2019

ACO roundup: BCBS of North Carolina, hospital systems launch new value-based care model

Daily Briefing
    • How Saint Francis built a 'hospital within a hospital' for joint replacements (and cut readmissions below the national average). To prepare for a projected rise in hip and knee replacements, Saint Francis Hospital and Medical Center (SFHMC) in 2007 launched its own bundled-payment program and soon after saw readmission rates and lengths of stay for the procedures fall below the national average, John Grady-Benson and his colleagues write in NEJM Catalyst. After a team of surgeons in 2007 established the Connecticut Joint Replacement Institute (CJRI) at SFHMC, the hospital saw the average length of stay for a knee replacement fall to 2.1 days, which is lower than the national average of 3.4 days, and the average length of stay for a hip replacement fall to 1.9 days, which is lower than the national average of 3.4 days. In addition, SFHMC also saw hospital readmission rates and infection rates for the procedures fall below the national average, while bolstering patient satisfaction from 82% to 98%.

    • BCBS of North Carolina, hospital systems launch new value-based care model. Blue Cross Blue Shield of North Carolina announced that it has partnered with five health systems—Cone Health, Duke University Health System, UNC Health Care, Wake Forest Baptist Health, and WakeMed Health 7 Hospitals—to launch Blue Premier, a new value-based care model that's similar to Medicare's Next Generation ACO program. Under the arrangement, the health systems will get bonuses if they meet quality and cost-of-care goals or share in financial losses if they miss those goals. BCBSNC has pledged to have all of its customers covered under Blue Premier agreements within five years.

    • UnitedHealthcare, Southeastern Health Partners establish new value-based care program. UnitedHealthcare (UHC) this month announced a new accountable care program with Southeastern Health Partners (SEHP), an ACO that includes AnMed Health, Bon Secours St. Francis, and Spartanburg Regional Healthcare System. [Editor's note: Daily Briefing is published by Advisory Board, a division of Optum, which is a wholly owned subsidiary of UnitedHealth Group. UnitedHealth Group separately owns UHC.] Under the agreement, UHC will share medical data on about 16,000 patients with SEHP to help SEHP curb duplicate testing and facilitate physician coordination across all the hospitals included in the ACO. In addition, the new program intends to spot patients who have a high risk of chronic disease and cut unnecessary ED visits and hospital readmissions.

    From Advisory Board:

    • MACRA 101. Join us for 30 minutes on Thursday, January 31, at 3:00 p.m. ET where we'll break down MACRA's origins and provide an introduction to the two Quality Payment Program (QPP) tracks: the Merit-Based Incentive Payment System (MIPS) and the Advanced Alternative Payment Model (APM).

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