OSF & Blue Cross Blue Shield of Illinois ACO
Program Location:
Chicago, IL
Payer Type:
Commercial
Parent Program:
Payers:
Blue Cross Blue Shield of Illinois
Reported Outcomes
Description:
Blue Cross and Blue Shield of Illinois (BCBSIL) and OSF HealthCare, a system owned and operated by The Sisters of the Third Order of St. Francis, Peoria, Illinois, formed an Accountable Care Organization (ACO) in January of 2014. By doing so, the two organizations aim to deliver improved patient care while also focusing on the overall cost of health care.
OSF is one of the largest health care systems in Illinois, serving more than 3.5 million people. The new ACO will see health care providers realign their focus from fee-for-service volume to a value approach for services designed to improve quality outcomes and patient satisfaction. At the same time, incentives are structured to focus on delivering more services to the patients in greatest need to avoid the consequences of unmanaged or poorly managed disease.
The agreement covers nearly 40,000 OSF patients and BCBSIL members. The ACO applies to the BCBSIL commercial fully insured and self-insured populations in Pontiac, Bloomington, Galesburg, Peoria, and Rockford. The partnership represents BCBSIL’s continued commitment to embracing and fostering value-based care delivery models like ACOs and its Intensive Medical Home model. All are designed to reward physicians for focusing on managing costs and quality simultaneously, and are intended to move the health care system from its traditional fee-for-service volume approach to a fee-for-value payment model.
Payment Model:
The ACO’s objective is to transform the way physicians and hospitals coordinate and deliver patient care by providing financial incentives for delivering even greater quality patient outcomes and satisfaction. The ACO aims to reward physicians for focusing on managing costs and quality simultaneously, and are intended to move the health care system from its traditional fee-for-service volume approach to a fee-for-value payment model.
Fewer ED / Hospital Visits:
The cost reduction was coupled with improved clinical outcomes for patients, such as lower readmission rates.
Cost Savings:
Over the first three years of the ACO agreement between Advocate and BCBSIL the medical cost trend was reduced by six percent when compared to the rest of the BCBSIL PPO population in the market.
Last updated June 2019
