In the beginning, an estimated 500 to 1,000 of Blue Florida's commercial members are expected to be part of the ACO. There are plans to expand the program to its Medicare Advantage members in South Florida.
The ACO will look at clinical outcomes tied to readmission rates, adherence to chemotherapy regimens, and adherence to accepted clinical guidelines as well as the efficiency of care delivered to the patient.
Gavras declined to discuss the financial arrangements for the ACO but said the upfront costs include analytics. "This is a data intensive process. The amount of data and information that has to be pulled together and gone through is enormous. This is not easy stuff." Florida Blue will provide much of the data analysis. AMS will maintain the electronic medical records.
The Unsettled State of the ACO