Thursday, November 21, 2013

Blue Cross and Blue Shield of Texas and Tenet Healthcare Corporation Collaborate on Statewide ACO to Improve Quality and Efficiency of Care

New commercial ACO agreement is among most innovative in the nation.

RICHARDSON, Texas and DALLAS, Nov. 12, 2013 /PRNewswire/ --Blue Cross and Blue Shield of Texas (BCBSTX) and Tenet Healthcare Corporation (Tenet) have agreed to collaborate to offer an innovative, statewide accountable care organization (ACO) model to deliver improved, sustainable patient care and help manage costs through Tenet's Integrated Care Networks. The collaboration is planned to be available to BCBSTX PPO commercial patients at any of Tenet's Texas hospitals with an Integrated Care Network beginning Jan. 1, 2015. The agreement may be expanded to include health insurance marketplace patients over the life of the agreement. Tenet's Texas Integrated Care Networks currently include South Texas Care Connect in San Antonio, Physician Performance Network of Houston and the Sierra Providence Physician Performance Network in El Paso.

The statewide ACO is targeted to include healthcare providers from all of Tenet's Texas markets and will advance the future of healthcare by transforming the way physicians coordinate and deliver patient care by reducing unnecessary hospital admissions, readmissions, ER visits and duplication of services for patients with chronic diseases, leading to lower costs.

"This collaboration with Tenet Healthcare reinforces both organizations' commitments to improving the quality and efficiency of healthcare services," said Jack Towsley, Divisional Senior Vice President, Texas Health Care Delivery, BCBSTX. "It also furthers Blue Cross and Blue Shield of Texas' efforts to establish innovative, value-based care delivery models designed to reward healthcare providers for managing costs and quality while realigning the focus from volume of services to the value of services."

"We are proud to partner with Blue Cross and Blue Shield of Texas on this strategic alliance, which represents the many innovative approaches to healthcare delivery that Tenet and Blue Cross and Blue Shield of Texas continue to provide to their communities and customers," said Clint Hailey, Chief Managed Care Officer for Tenet Healthcare. "Tenet has a long history of successful collaborations with physicians and payers, and this arrangement will capitalize on the physician-led organizations that have developed robust clinical programs to improve care delivery across the service continuum."

"In addition to shifting the way we have traditionally paid for services, the ACO model will allow us to use our time and resources to implement strategies to improve the overall patient experience," says Dr. Dan McCoy, Chief Medical Officer, BCBSTX. "Establishing this arrangement with Tenet will help BCBSTX to provide our members with both lower costs and improved quality of care."

This new model of healthcare delivery is designed to improve outcomes in three key categories: quality of care, patient experience and satisfaction and cost efficiency. It will reach those goals by pursuing the following strategies:

  • Early identification of disease and illness through effective management and coordination of patient care;
  • Use of advanced technology and support services to make more informed decisions and facilitate the patient and provider relationship and transitions in care;
  • Implementing an alternative or non-fee-for-service payment arrangement, and
  • Lowering cost trends by coordination among payers and providers, without limiting medically necessary services in order to enable the delivery of more affordable healthcare products.

Tenet Healthcare has been advancing the concept of better care coordination for more than a decade. Conifer Health's Value-based Care division will support this ACO project by identifying care improvement, efficiency and service opportunities. As one of the nation's largest employers, this endeavor furthers Tenet's commitment to the long-term health status of its communities.

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