By Gregg A. Masters, MPH
One of the last ‘super PHOs’ standing circa the blood bath, grand ‘risk push-back’ and subsequent unwinding of many physician/hospital JVs of the 90s, Advocate Health Partners (aka @AdvocateHealth) and it’s aligned payor partner, Blue Cross and Blue Shield of Illinois (aka @BCBSIL) went public with their commercial ACO results last week. For complete announcement, click here.
The net takeaway can be summarized as follows:
[though limited to 6 months of data] results thus far are inconclusive but are encouraging
Advocate Health Care is by anyone’s definition a mature integrated delivery system emerging from the independent physician community space though tethered to an institutional partner, vs. the retooling of a closed system to more effectively integrate with the private medical community, i.e., Kaiser, Mayo et al.
The piece, though clearly hedging a ‘good news and bad news’ message, none-the-less settles on the upside of proactive collaboration by the provider community with their local market payor partner.
Yet, what I find of particular interest and worthy of further consideration is the comment proffered by author, lecturer and seasoned veteran in the HMO, and managed competition space, William DeMarco as follows:
This is not an Accountable Care Organization as the shared savings formula and results of quality improvement are put on the back burner in favor of replacing revenue lost in inpatient care. Bundled payment BY ITSELF will not improve care or make providers remove waste from the system, rather providers will merely try and recover what they were loosing by delivering preventable and avoidable care.
So what do you think? Is Bill being too hard on Advocate et al? Or might we be best advised to let ‘innovation’ manifest granularly by local communities of practice vs. against the rules as codified by CMS in the Affordable Care Act & sequelæ?