New Jersey health system builds big ACO
Eight-hospital Barnabas Health in New Jersey is launching an accountable care organization program with the state's largest insurer intended to both lower costs and improve care quality. The ACO go-live date is September 1.
Barnabas Health, New Jersey's largest hospital healthcare delivery system, is collaborating with Horizon Blue Cross Blue Shield of New Jersey on the new care model. Under this ACO agreement, officials say Horizon BCBSNJ will extend care coordination payments to the ACO, taking on accountability for improving the health, patient experience and controlling the cost of care for its Horizon BCBSNJ Medicare Advantage patients.
The ACO and its affiliated practices have an opportunity to share in the resulting savings, provided the ACO meets certain health improvement, patient satisfaction and cost goals.
[See also: Pioneer ACOs show savings.]
"As we enter a new age of healthcare, in which we will be responsible for managing populations of patients, the relationships we establish must share our values of improving the quality, access and efficiency of the care we deliver," said Anthony Slonim, MD, executive vice president and chief medical officer of Barnabas Health and president of the Barnabas Health Medical Group, in a news release.
This collaboration with Barnabas Health, through its affiliated accountable care organizations, Barnabas Health ACO-North and Central Jersey ACO, marks the health insurer's fifth ACO or population health initiative to launch within the past year. More than 320,000 members and 1,400 doctors are participating in Horizon BCBSNJ’s patient-centered programs.
"Collectively, these accountable care innovations inject a new level of collaboration and quality standards into our health delivery system and help remove wasteful, unnecessary costs," added Jim Albano, vice president of network and Horizon Healthcare Innovations, Horizon BCBSNY, in a news release.
In recent years, there have been a surge in these private ACO contracts among national and regional health insurers.
Just this July, health insurer giant UnitedHealthcare announced it would double its ACO contracts over the next five years, representing more than $50 billion of reimbursements by 2017.
[See also: ACO rules need to level competition.]
In terms of payment models, commercial payers, such as BCBSNJ, are less likely to offer upside-only payment structures, according to a recent Premier healthcare alliance report that found more than one-third of ACO arrangements have an upside-only agreement – most of them being Medicare programs.
With an upside-only payment structure, if providers fail to achieve certain financial goals, they aren’t faced with needing to reimburse money for failing to meet their goals.
It's estimated that some 31 million Americans now receive healthcare through an accountable care organization, according to a recent report from Oliver Wyman, with 8 million to 14 million of them being part of private ACOs launched by national and regional insurers for non-Medicare populations.
