More than 560,000 BlueCross BlueShield of Tennessee members in Middle Tennessee will have an accountable care health plan option starting next year that includes health coaching, home visits, preventative health checkups and other services from MissionPoint Health Partners.
The four-year arrangement is the latest partnership created by MissionPoint, an accountable care organization that’s part of the Saint Thomas Health hospital system and was launched one year ago. Officials said Tuesday that MissionPoint has exceeded goals for signing up providers and members, posted cost savings in the first year and landed other key partnerships, such as being picked by department store Kohl’s to build on-site clinics at its facilities nationwide.
But the highlight is the partnership with BlueCross, which adds a payer with customer service, claims administration and prompt provider payments capabilities, while also expanding the reach of the MissionPoint network. “It’s really now bringing a kind of pinnacle payer experience with a really best-in-class clinical experience,” said Jason Dinger, CEO of MissionPoint. “By partnering with BlueCross…, it allows us to continue to focus on our quality and cost outcomes, which are our differentiators in the marketplace.”
Accountable care organizations are designed to bring together groups of health care providers who provide coordinated care and chronic disease management in an effort to improve the quality of care and reduce costs. “Partnering in an ACO with Saint Thomas is good for their patients, it’s good for our customers, it’s good for the hospitals and physician and it’s definitely good for BlueCross,” said Larry Nall, senior vice president of provider network manager with the state’s largest health insurer based out of Chattanooga.
‘Care stays close’
Dinger reported progress in MissionPoint’s first year, including having more than 50,000 members (it started with 15,000 members, who were mainly Saint Thomas Health employees). It has more than 1,500 doctors aboard, exceeding the initial goal of 400. In the first year, MissionPoint achieved 12.2 percent, or roughly $5 million, in savings on those first 15,000 members.
Dinger also announced Tuesday that hospital system Capella Healthcare’s corporate offices and four rural Middle Tennessee hospitals owned in a joint venture with Saint Thomas Health are now part of MissionPoint. “We believe that partnering with rural hospitals is key to ensuring that care stays close to the home,” Dinger said.
MissionPoint also is expanding the Kohl’s department stores’ wellness centers that offer care for workers and dependents, including adding clinics at call centers and distribution centers in Texas and California. “We’re ecstatic because we now have the ability to also reach the place of employment for folks,” Dinger added.
MissionPoint also has a partnership with LEAD Public Schools to offer free services to the charter schools operator’s 970 students, their families and its full-time staff of 125.
Larry Kloess, a former Nashville area hospital executive now a senior adviser to local venture capital fund, said health systems in implementing ACOs under current regulations must be cautious to determine the right time to transition to the new model of delivery.
“If you do it too soon, the payment system may not be in place to cover the infrastructure costs associated with risk contracting,” he added. “If you wait too late, the health system will find itself catching up to the marketplace.”