Blue Shield of California Providence Health & Services and Others Collaborate on Accountable Care

SAN FRANCISCO, CA (July 25, 2013)--- Blue Shield of California, Providence Health & Services, Southern California and its affiliates Facey Medical Foundation and Facey Medical Group announced today a three-year accountable care initiative to provide integrated, cost-efficient care to approximately 16,500 Blue Shield HMO members in Los Angeles County. About 5,500 of these enrollees are members of the California Public Employees’ Retirement System (CalPERS). The organizations expect this collaboration to result in flat or decreased healthcare cost trends for these members during the three years of the collaboration.

To achieve this goal, the healthcare organizations have formed an Accountable Care Organization (ACO) to share clinical and case management information and coordinate comprehensive healthcare services for Blue Shield HMO members assigned to Facey Medical Group physicians. The ACO includes three medical centers: Providence Holy Cross, Providence Tarzana and Providence Saint Joseph. With the goal of keeping health care affordable for local Blue Shield members and employers, a multidisciplinary team representing each organization is identifying and implementing long-term strategies aimed at improving quality and efficiency. The organizations’ incentives will be aligned to improve healthcare quality and patient service while reducing costs.

The organizations began working together in January 2013, and the ACO recently was approved by the state Department of Managed Health Care (DMHC). The initiative will continue at minimum through 2015. The organizations intend to extend the collaboration even longer in order to have a material, sustainable impact on healthcare costs for members and employers over time. The goal is to build a care delivery model that improves quality through better coordination of care while removing unnecessary costs from the healthcare delivery system.

Providence and Facey leaders say the establishment of this new ACO aligns with their organizations’ strategic plan to establish healthcare delivery systems that feature high-quality, safe and affordable care.

"In this era of healthcare reform, Providence is committed to working with partners to expand access to quality, affordable healthcare," said Dale Surowitz, chief operating officer of Providence Southern California. "This ACO provides a framework for our hospitals and our physicians to work as a team to provide the best care for each patient, with the aim of improving quality while reducing costs."

Teresa David, chief operating officer at Facey Medical Foundation, said: "This ACO relationship will promote the collaboration and information-sharing among physicians, hospitals and Blue Shield that is essential to delivering quality patient care. We are excited about the opportunity to use innovative strategies to create efficiencies and improved practices that will lower the costs of providing health care to our communities."

The collaboration is Blue Shield’s 10th commercial ACO. Blue Shield currently works with hospitals, physician groups and employers to deliver integrated care to more than 160,000 members in Sacramento, San Francisco, Contra Costa, Santa Cruz, Stanislaus, Los Angeles and Orange counties.

"This collaboration is another important step in our ongoing effort to align incentives across the healthcare delivery system in order to transform how care is delivered and control the healthcare cost trend," said Kristen Miranda, vice president of strategic partnerships and innovation at Blue Shield of California. "Providence and Facey have shown an incredible level of commitment to this work already, including setting aggressive cost and quality improvement goals. We’re confident they’ll be great long term partners."