Providers take own direction with ACOS
Providers take their own path with ACOs in California, Tennessee
Hospitals are cool to the CMS’ proposal for accountable care organizations, but providers in two states announced last week plans for ACOs that aren’t dependent on the CMS framework.
Nashville-based St. Thomas Health is creating a partnership akin to an ACO that will be rolled out in January for hospital system employees and their dependents—15,000 people total, according to a news release. St. Thomas is a member of St. Louis-based Ascension Health. Meanwhile, in California, an independent practice association and Anthem Blue Cross, Woodland Hills, announced a contract that sets up a private ACO in Santa Clara County.
In Tennessee, the new MissionPoint Health Partners will bring together local care providers and national technology vendors. Provider par- ticipants are St. Thomas, which has four hospitals and a stake in a spinal hospital, and 200 St. Thomas-affiliated physicians. MissionPoint will use the telemedicine platform of San Jose, Calif.-based Cisco Systems and will look to Applied Health Analytics, Nashville, to provide members with health-risk assessments and personal health plans. Other MissionPoint partners are Crimson Services, an initiative of the Washington-based Advisory Board Company that offers a physician data analytics platform to promote better physician performance, and the YMCA of Middle Tennessee.
MissionPoint is starting with a self-insured employer population, but that’s only one of five populations it intends to cover, CEO Jason Dinger said in an interview. The others are commercially insured, managed Medicaid, Medicare ACO and uninsured popula- tions, Dinger said. By partnering with other area hospitals, MissionPoint hopes to realize shared savings from managing the care of uninsured individuals, he said.
Once the infrastructure is in place for managing population health, it makes sense to apply that infrastructure to as many patients as possible, to spread the fixed costs over more covered lives, Dinger said. “We really believe that working with population health, you need to develop a platform for that and then be able to modify that platform for different populations.”
MissionPoint hopes to add 10,000 to 20,000 individuals a year to its membership roster, Dinger said.
Anthem’s agreement is with the Individual Practice Association Medical Group of Santa Clara County, San Mateo, Calif. The private ACO, which is unrelated to the CMS initiative to launch ACOs nationwide for Medicare patients, is expected to enroll “tens of thousands of PPO members” who are already patients of the partnering physician group, according to an Anthem spokeswoman. The physician network includes 284 primary-care physicians, 550 specialists and 10 acute-care facilities.
— with Rich Daly