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.

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.

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Source: Chicago Healthcare Daily