Health care providers in Wellmark program see more than $17 million in savings
BUSINESS RECORD STAFF Sep 3, 2015 | 3:43 pm
2 min read time
462 wordsAll Latest News, Health and Wellness, InsuranceEight Iowa health systems participating in a shared savings model of care with Wellmark Blue Cross and Blue Shield collectively saved more than $17 million in health costs in 2014, Wellmark announced this morning.
Under the accountable care organization (ACO) model, health care systems are rewarded by insurers for improving quality of care and effectively managing costs. The health care providers assume responsibility for managing a population of patients, both those who are healthy and those who are in need of care.
Wellmark offers the ACOs financial rewards if they reach established quality goals and slow the rate of increase in health care spending for their patients. At the same time, providers will not earn their incentives if their quality declines or their costs run higher than expected.
The eight ACOs, representing more than 424,000 members, achieved savings by reducing hospital admissions by nearly 11 percent, readmissions by 8 percent and emergency department visits by 10 percent, according to Wellmark.
A year ago, Wellmark announced that an initial group of five participating health systems collectively improved their quality of care by more than 35 percent and saved more than $12 million in their initial two years under ACO contracts with Wellmark. Those dollar savings had equated to an overall reduction in health care costs of 1.5 to 2 percent, Wellmark said last year.
Rewarding health systems for collaborating to improve quality of care and effectively manage costs is continuing to make a measurable difference, said Mike Fay, Wellmark’s vice president for health networks.
“We are pleased and encouraged by the 2014 results and our members should be too because this ultimately leads to better value for their health care dollar,” Fay said in a release.
In addition to favorable results for hospital-based savings, preventive care services for participating members increased over the previous year, Wellmark said.
In 2014, there were an additional 21,000 visits to primary care physicians, an additional 2,500 women received mammograms, 1,500 more children received preventive visits and 1,100 more members were screened for colon cancer over the previous year. Also, many of the ACOs improved their continuity of care score, which means members received more coordinated care when needed.
The eight health systems included in the 2014 ACO data are UnityPoint Health, Mercy Medical Center – Des Moines, Genesis Health Systems, the Iowa Clinic, McFarland Clinic, Family Healthcare of Siouxland, Wheaton Franciscan Healthcare and a collaboration between Mercy Medical Center – Cedar Rapids and University of Iowa Hospitals and Clinics.
Wellmark’s ACOs are comprised of members with fully insured health insurance plans. Earlier this year, Wellmark established ACO shared savings relationships with five additional health systems: Great River Health System, Mercy Iowa City, Nebraska Methodist Jennie Edmundson Hospital, Mercy Medical Center – Mason City, and Pella Regional Health Center.
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