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New Insurer-Hospital ACO claims early success

March 8th, 2012 - (KHN) -Quality and efficiency in Healthcare


Illinois’ largest hospital system and biggest health insurer agreed in late 2010 to form an Accountable Care Organization, a network in which the organizations would cooperate to boost quality and restrain cost increases, sharing in any savings.


With six months of operating data in hand, Advocate and partner Blue Cross Blue Shield of Illinois claim spending reductions that are greater than those for patients outside the network.


Key to the results were the hiring of 60 “care managers,” many embedded in physician practices, to manage high-risk cases and post-acute care, said Lois Elia, vice president at AdvocateCare.


Six months of data do not guarantee success of the three-year experiment. “This is good but too early to draw conclusions,” Elia said.

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