Provider-payer ACO cuts readmissions by 26%

The provider-payer accountable care organization between Illinois' largest hospital system, Advocate Health Care, and Blue Cross Blue Shield of Illinois is showing strong first-year results with lower readmission rates, suggesting improved patient care, the Chicago Sun-Times reported.

AdvocateCare, the largest commercial ACO with 380,000 members, saw readmission rates for chronic conditions drop 26 percent, thanks to transition coaches.

Meanwhile, ACO patients sent to nursing facilities had a 13.6 percent readmission rate during the first year of operation, falling below the 20 percent national average, noted the Sun-Times.

"Our keen focus on care coordination, prevention, early detection and education is ensuring our patients receive the right care, at the right time and at the right place," Advocate Health Care system Executive Vice President and Chief Medical Officer Lee Sacks told the newspaper.

After only six months of data, AdvocateCare declared success. During the first half of 2011, the ACO led to a 10.6 percent drop in hospital admissions per member, compared to 2010, and a 5.4 percent  decline in emergency department visits, FierceHealthcare previously reported.

But not everyone is sold on the new delivery model, as critics note the difficulty to meet all four goals of high quality, affordability, accessibility and universal coverage, the Sun-Times noted.

Nevertheless, Advocate continues to embrace accountable care, with one of its physician groups among the 89 new additions to the Medicare Shared Saving Program announced last month, noted the Chicago Tribune.

To learn more:
- read the Sun-Times article
- here's the Tribune article