- Hospitals signed up for Philadelphia-based Independence Blue Cross have gotten some meaningful results out of the program, according to the health plan.
- During the first full year of the program—which included 90% of the region's delivery systems—half of hospitals cut costs for IBC members.
- Nearly 90% of hospitals lowered their readmission rates, with an average drop of 16%. Also, every one improved in the area of hospital-acquired infections or took honors from state regulators for infection control.
In IBC's version of the ACO, hospitals and doctors created ACO entities which share risk with the insurer, targeting clinical performance improvement and cost efficiency. Half the hospital and physicians' possible earnings are based on performance improvement in key areas such as hospital-acquired infections, surgical care and readmissions. The other half of possible earnings comes from managing costs across inpatient, outpatient and ancillary care, plus home health and prescription drugs. Due to the program's initial success, IBC will probably dole out more than $150 million in incentives this year.
This is encouraging news for fans of the ACO model, some of whom are just getting started. While it's not clear how replicable these gains are, they're worthy of study and attention. Meanwhile, let's see if other ACO success stories come flooding in this year from other corners.