Anatomy of an ACO
Through its systemic approach to quality, Mountain States Health Alliance has positioned itself to have a regional role in the world of accountable care. It has the only ACO in its market, A new Care Collaborative, which in July was accepted to participate in the Medicare shared-savings program. A family of organizations creates the underlying structure of A new Care. They are:
Crest Point Health, a third-party health plan administrator. Currently managing the health of all Mountain States employees (about 15,000 covered lives), Crest Point will be contracting with A new Care as a payer. Crest Point also plans to offer standard insurance products for businesses, and will launch a Medicare Advantage plan for individuals this fall.
Integrated Solutions Health Network, the holding company of A new Care and Crest Point, is responsible for network development, provider credentialing and contracting. Mountain States is Integrated Solutions’ parent company and major stakeholder.
Blue Ridge Medical Management Corp., a wholly owned for-profit subsidiary of not-forprofit Mountain States, manages the Mountain States Medical Group.
Mountain States Medical Group, part of Blue Ridge Medical Management Corp., employs about 400 physicians in primary care and specialties. The medical group is responsible for delivering patient-centered care and the development and deployment of the patientcentered medical home from which the ACO members receive care.