Blue Cross Blue Shield of Texas has formed one of the largest accountable care organizations in the country, partnering with healthcare provider Texas Health Resources to improve quality and decrease costs.
The new partnership aims to increase care coordination and management, as well as reimburse participating providers based on value instead of volume. BCBSTX and Texas Health, which operates 25 hospitals and is affiliated with more than 5,500 doctors, will better deploy and use technology to make more informed decisions, facilitate the patient-provider relationship and improve transitions in care, The Dallas Morning News reported.
By implementing these key steps, the BCBSTX-Texas Health ACO should reduce unnecessary hospital admissions and readmissions, emergency room visits and duplication of services for patients with chronic diseases, reported D Healthcare Daily.
"Our agreement is a game changer. We will move reimbursement from fee for service to fee for value," said Eduardo Sanchez, vice president and chief medical officer for BCBSTX. "In addition, we will better harness clinical data to drive medical care decision-making, enhance patient safety and improve quality of care--all in the name of better health and better outcomes for patients."
Sanchez added that sharing robust data will help BCBSTX more accurately predict its members' medical costs, regardless of their age, reported the Fort Worth Star-Telegram. The ACO payment model has more sophisticated risk adjustment, he added. "That's very different than 15 or 20 years ago."