Pennsylvania's smaller Blue-licensed insurer is boasting of some notable results in its accountable care arrangements and is looking to bring similar contracts to small primary care practices.
Harrisburg-based Capital BlueCross is pointing to fresh data supporting its four-year effort to adopt a variety of value-based arrangements with area providers--reduced acute inpatient hospitalizations and readmissions among both employer group and Medicare Advantage members.
In the most recent 12 month period, Capital BlueCross' seven "accountable care arrangements" with large physicians practices and hospital systems have, compared to other contracts, seen inpatient admissions decline by 4.7 percent for group members and 7.2 percent for seniors.
Readmissions among members treated by accountable care contracted providers are down 8 percent in group plans and 14 percent in Medicare plans. Emergency room visits are down in similar ranges, about 8 percent for both employer group and senior members.
Overall, medical and pharmacy costs for accountable care arrangements--covering some 130,000 central Pennsylvania residents-- are growing at a slower rate than the insurer's overall book of business. The company didn't give exact details, but said the numbers "compare favorably" to similar contracts in use by other Blue plans across the country.
"As healthcare continues to evolve at a rapid pace, it is important for health insurers to remain focused on finding better ways to improve the quality of care, while putting downward pressure on the rising cost trend," said Jennifer Chambers, MD, Capital BlueCross chief medical officer.
"We have done just that over the past four years by collaborating with area providers to implement accountable care arrangements throughout the region," said Chambers, the former director of Palliative Medicine at Penn State Milton S. Hershey Medical Center. "Not only has our model been enthusiastically embraced by physicians and their patients, but this holistic approach to medical care is working as we had hoped."
In other measures, providers in Capital BlueCross' accountable care program are exceeding the regional average for Healthcare Effectiveness Data and Information Set metrics in a number of chronic disease areas, with some providers in the 95th percentile for the comprehensive diabetes care.
The insurer is also starting up an accountable care program called Quality First designed for small and mid-size independent primary care practices.