BLOOMINGTON — OSF HealthCare and Blue Cross and Blue Shield of Illinois will announce Thursday their intention to form a strategic alliance called an accountable care organization.
ACOs are groups of doctors, hospitals and other health care providers who come together voluntarily to give coordinated, high-quality care to their Medicare patients, according to the Centers for Medicare & Medicaid Services.
The goal is that patients, especially the chronically ill, get the right care at the right time while avoiding duplication of services. If they succeed, ACOs eventually should result in cost savings.
Peoria-based OSF is among 32 organizations selected by Centers for Medicare & Medicaid Services for participation in the Pioneer ACO pilot with the federal government. Pioneers are health care organizations with experience in coordinating care for patients in different settings.
The OSF ACO will see health care providers switch from a fee-for-service to a fee-for-value approach designed to improve outcomes and patient satisfaction. Doctors and other providers will be given financial incentives for delivering quality patient outcomes while managing costs.
“Patients are going to notice the increased attention and services when they are most in need or at risk for complications from a condition,” OSF CEO Kevin Schoeplein said in a prepared statement. “Blue Cross will reward us for success and we’ll realize reduced reimbursements where we miss the mark. In the end, everyone wins by driving improvement.”
The ACO will identify patients with chronic disease and have programs to help people to better manage their health to reduce unnecessary hospital admissions, emergency department visits and duplication of services.
The agreement will begin Jan. 1 and will cover nearly 40,000 OSF patients and Blue Cross and Blue Shield members, including in the Bloomington-Normal and Pontiac areas.
Dr. Opella Ernest, Blue Cross vice president and chief medical officer, said, “We’ll take better advantage of clinical data between our two organizations to assist in wise, medical care decision-making and improve patient safety.”