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New Statewide ACO Model Comes To Texas To Improve Quality & Care

by Jasmine Pennic 11/13/2013 Leave a Comment

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Blue Cross and Blue Shield of Texas and Tenet Healthcare Corporation have agreed to collaborate to offer an innovative, statewide ACO model to deliver improved, sustainable patient care and help manage costs through Tenet’s Integrated Care Networks. 

According to the announcement, 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.

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.

“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. Establishing this arrangement with Tenet will help BCBSTX to provide our members with both lower costs and improved quality of care,” says Dr. Dan McCoy, Chief Medical Officer, BCBSTX

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.

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.

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