Blue Shield of California’s Altais reached a deal Thursday with the California Medical Association (CMA) and the startup Aledade as part of an ongoing effort to provide technology and services aimed at enhancing value-based care.
The deal comes a few months after CMA, which represents more than 44,000 physicians, reached an agreement with Aledade to expand the number of physician-owned accountable care organizations (ACOs) in the state. Altais provides clinical support tools and services to physician practices to help reduce administrative burden.
“We're thrilled that our first announced initiative is a collaboration to bring technology and services that will help physicians flourish under value-based arrangements, which are becoming a mainstay of modern healthcare,” said Altais CEO Jeff Bailet in a statement.
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Aledade, a startup that recruits and assists doctors in propping up an ACO, and the CMA reached the deal back in May to create new physician-led ACOs. The first ACO as a result of the partnership will launch in January.
The Maryland-based Aledade already operates 20 ACOs across 24 states. Blue Shield also announced it will become the first payer to offer a value-based agreement for physicians working with Altais available sometime next year.
“This partnership will help CMA in its mission to bring more common-sense reforms to our health care system and improve the lives of physicians and their patients,” said CMA President David Aizuss.
Physician-led ACOs have been money savers for Medicare. A 2018 analysis published in the New England Journal of Medicine found that physician ACOs generated $256 million in savings for Medicare in 2015. However, spending cuts in hospital-led ACOs were offset by bonus payments, the analysis found.
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Last month, major changes to the Medicare Shared Savings Program, which oversees ACOs, were implemented. The new changes require both physician and hospital ACOs to take on downside financial risk within two years.
An ACO can initially take on one-sided risk, where they don’t have to pay back the government for missing savings thresholds for two years, and then must transition to downside risk over three years.