The formation of accountable care organizations (ACOs) has become a daily occurrence, and a couple names common to recent announcements are the health plans Aetna and Cigna.
First up, Aetna reached an accountable care agreement with Bon Secours Health System that will impact the care coordination and delivery for approximately 57,000 Medicare beneficiaries in Kentucky, New York, South Carolina, and Virginia as part of the Medicare Shared Savings Program. Aetna will also take over administering employee medical benefits for Bon Secours staff. Bon Secours will implement services from Aetna subsidiary Healthagen in the form of health information exchange and analytics, working in line with the healthcare organization’s existing EMR system.
The agreement between Aetna and Bon Secours follows less than a month after the health plan reached a similar agreement with Riverside Health System in Virginia, its third ACO contract in the state. In last month’s announcement, Bon Secours was listed as one of several organizations participating in Coastal Virginia Health Partners, a provider network also including Riverside, Children’s Hospital of The Kind’s Daughters and Chesapeake Regional Medical Center.
Aetna appears to have the Mid-Atlantic Region of the United States locked down.
Meanwhile, Cigna has made similar moves in Pennsylvania and Arizona. Earlier this week, the health plan based in Bloomfield, Conn., announced the launch of an accountable care initiative in partnership with Valley Preferred. The ACO targets improvements in care for 5,500 individuals insured by Cigna and receiving care from Valley Preferred primary care and specialty physicians.
Last week came the announcement of the collaboration of Cigna with Scottsdale Health Partners in Phoenix, Ariz. The ACO will benefit nearly 4,000 individuals insured by Cigna health plan and receiving care from SHP’s network of 480 primary care doctors and specialists.
The shift to pay-for-performance is most likely to benefit patients with chronic conditions, such as diabetes or heart disease.
“We need a patient-centered health care system that emphasizes prevention and primary care, and rewards physicians for quality of care and outcomes,” Julia Huggins, Cigna president and general manager for Pennsylvania, said in a public statement. “A system that’s focused on value rather than volume will ultimately lead to a healthier population and lower medical costs, which is good for individuals, families, employers and doctors.”
Effective July 1, the ACO agreement between Valley Preferred and Cigna is one of 66 collaborative accountable care initiatives the latter is launching in 26 states and which will bring more than 700,000 commercial customers and 27,000 doctors.
Although the ability of ACOs to impact the healthcare cost curve is not yet known, more and more of these organizations are taken shape across the country in the hope of combining care and cost management into a viable healthcare delivery solution.
Date: June 26, 2013