Arlington-based Texas Health Resources announced its second partnership with a major insurer this month, forming an Accountable Care Organization with Aetna barely two weeks after unveiling a similar agreement with Blue Cross Blue Shield of Texas.
Accountable Care Organizations typically involve teams of medical providers, like hospitals and doctors, and can also include insurers. The role of an ACO is to actively manage its members’ health status, such as devoting extra resources to a patient with a chronic condition like diabetes, and focusing on preventive measures.
ACOs also often assume some measure of financial responsibility for members’ medical expenses, which can mean rewarding medical staff for keeping patients healthy.
THR and Aetna said their agreement “features a new payment model that will reward physicians for meeting quality, efficiency and patient satisfaction measures.” Those include reducing hospital readmissions and emergency room visits.
THR spokesman Wendell Watson said Tuesday that more ACOs are likely to be formed this year by THR, which has 25 area hospitals and whose Texas Health Physicians Group includes more than 750 doctors, nurse practitioners, physician assistants and medical professionals.
The likely partners include both major insurers and major employers, he said.
Ralph Holmes, president of Aetna’s Texas operations, said the THR physicians “will lead the team in a care environment that focuses on improving quality, reducing cost and delivering more value to the patient.” Aetna says it has 37 million U.S. members.
In a prepared release, Dr. Michael Stoltz, president of Texas Health Physicians Group, said, “One of our goals is to provide physicians with better predictors of health risk earlier in a patient’s life. By implementing behavior interventions early, we can improve health and outcomes in the long term.”