During a six-month period, Anthem Blue Cross and HealthCare Partners reported an 18% decrease in the length of hospital inpatient stays for patients in their southern California accountable care organization compared to patients outside the ACO.
Anthem Blue Cross and HealthCare Partners Medical Group have announced that their ACO generated an estimated $4.7 million in savings in the first six months of 2013 by shortening hospital stays and reducing the incidence of ED visits among participants.
The ACO involves more than 52,000 Anthem PPO patients in Southern California cared for by HealthCare Partners, a medical group with more than 6,300 primary care physicians and specialists. During the six-month study period, Anthem and HealthCare Partners reported an 18% decrease in the length of hospital inpatient stays for the ACO group compared to patients outside the ACO.
The incidence of both hospital visits and outpatient visits—including ED visits—declined 4%. Members also reported 4% fewer lab visits and radiology visits and slightly better results in managing cholesterol levels and blood sugar levels.
"Until now, the promise of better care and lower costs via ACOs in the commercial PPO population has not been clearly documented," said Mark Morgan, president of Anthem Blue Cross. "Through the collaboration of medical teams at Anthem and HealthCare Partners, we are able to provide one of the first well-documented reductions in medical cost trends in the national commercial PPO space."
While HealthCare Partners is currently involved in several ACOs in the state, spokesman Robert Klein said the partnership with Anthem marked its first venture with PPO patients. HealthCare Partners established a specialized ACO unit that includes a group of case managers who track hospitalized ACO members and coordinate transitions of care.
It also established a medical management program to help ACO patients with chronic diseases and to coordinate home care and palliative care for patients.
Anthem Blue Cross spokesman Darrel Ng said the insurer took a different approach to the ACO that included paying HealthCare Partners a management fee. "We paid an upfront management fee and shared a lot of information with them on what patients were doing outside of the network," said Ng. "That information helped them reach out to patients."
Michael Belman, MD, medical director for Anthem Blue Cross, said cost savings produced by the program "show the synergies achievable with close collaboration between a health plan and a well-organized medical group like HealthCare Partners. By sharing a rich set of health-related information on our members with HealthCare Partners, we were able to facilitate their work in effectively managing these patients."