November 1, 2016
Creating an opportunity for solo practitioners and independent primary care practices to participate in a value-based reimbursement program is the driving force behind Blue Cross and Blue Shield of Kansas partnering with Aledade, Inc., to form an accountable care organization (ACO) for the insurer's contracting providers.
"Our new partnership with Aledade allows us to extend value-based reimbursement opportunities to smaller provider offices, many of which represent the backbone of medical care in our rural communities," said Andrew C. Corbin, BCBSKS president/CEO. "Aledade has a proven track record in Kansas with their Medicare ACO model. We share the common goal of wanting to reward our contracting providers for focusing on quality health outcomes for our members rather than the volume of health care services they can deliver."
The new partnership will expand Aledade's current physician-led ACO in Kansas that covers 11,390 Medicare beneficiaries. Approximately 23,000 BCBSKS members are currently served by the 15 primary care practices already in the Aledade Kansas ACO. But those numbers are expected to grow as more solo practitioners and independent primary physicians are recruited for the ACO.
“This partnership allows independent primary care practices in Kansas to take advantage of value-based opportunities with Blue Cross that have previously only been available to large physician networks and hospital providers," said Daniel J. Krifcher, chief commercial officer at Aledade. "Aledade believes primary care is the foundation of an effective health care system, and we’re excited for Kansas physicians to be at the forefront of providing high-quality, coordinated care in a scalable way."
BCBSKS will provide the ACO with expertise and experience in care management and quality improvement, as well as comprehensive patient care data. This gives the ACO’s physicians the ability to see beyond the walls of their practice for a comprehensive view of their patients’ health, empowering the physicians to provide more seamless care.
Aledade will provide primary care physicians with regulatory expertise; best practices from a national network of hundreds of primary care doctors; user-friendly technology and data analytics that provide visibility into the spectrum of care their patients receive outside their office; and face-to-face practice transformation support.
Corbin said that this type of agreement is a natural progression of the insurer's efforts to focus on quality outcomes and total cost of care as the health care system transitions away from the historic fee-for-service model.
"In the past few years, we've entered into ACO agreements in Wichita and Topeka with large hospital systems and provider groups, and have continued to see more and more providers interested in our patient-centered medical home program," Corbin said. "Creating an opportunity for the many small provider offices in Kansas to participate in these efforts is a natural, next step in moving toward a system that offers incentives that drive quality and improve the overall health of Kansans while better controlling health care costs in a way that has a positive impact on the premiums employers and consumers pay."
Aledade’s partnership with BCBSKS also represents an opportunity for doctors in Kansas.
“Partnering in an Aledade ACO has helped my practice implement the technology and population health management tools needed to deliver high-quality, coordinated care. This new partnership with Blue Cross will grant us comprehensive patient care data that benefits our patients by allowing us greater insight into their health and care throughout the health system,” said Jen Brull, M.D., physician owner at Post Rock Family Practice in Plainville and medical director for the ACO.
Currently, the Aledade Kansas ACO includes these 15 primary care practices throughout Kansas: Ashley Clinic, LLC, Chanute, Humboldt, Iola, Burlington, Independence, and Neodesha; Bacani McKenney Clinic, Fredonia; Bluestem Medical, LLP, Quinter; Complete Family Care, Lansing; Family Care Center, Winfield; Family Medicine Associates, P.A., Lawrence; Family Practice Associates of Western Kansas, LLC, Dodge City; Lawrence Family Practice Center, PA, Lawrence; Post Rock Family Medicine, Plainville; Republic County Family Physicians, Belleville; SEK Primary Care Associates, Neodesha; Winfield Medical Arts, PA, Winfield; Hillside Medical Group, Winfield; Stonecreek Family Physicians, Manhattan; and, Pratt Family Practice, Pratt.
For nearly 75 years, Blue Cross and Blue Shield of Kansas has built a reputation of trust with its members and contracting providers by providing outstanding customer service while quickly and accurately processing claims; fairly administering benefit plans and contracts; offering programs, services and tools to help members improve or maintain their health; and operating under the highest ethical standards while being good stewards of premium dollars. Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross Blue Shield Association and is the state’s largest insurer, serving all Kansas counties except Johnson and Wyandotte. For more information, visit bcbsks.com.
Founded in 2014, Aledade offers a new model of primary care that puts physicians back where they should be: quarterbacking their patients’ health care. Aledade partners with primary care physicians to build and lead Accountable Care Organizations (ACOs) that allow these doctors to stay independent, practice medicine like they’ve always wanted to, and thrive financially by keeping people healthy. Aledade provides data analytics and user-friendly technology to help doctors provide more seamless care, unparalleled regulatory expertise, the best practices shared by a national network of hundreds of doctors, and face-to-face practice transformation support. Based in Bethesda, MD, Aledade is led by CEO and co-founder Dr. Farzad Mostashari, former National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services. Since its founding in 2014, Aledade has established successful organizations in New York, Delaware, Maryland, Arkansas, West Virginia, Tennessee, Mississippi, Florida, Louisiana, Virginia, Kansas, Michigan, Utah, Missouri, and Pennsylvania which care for more than 200,000 patients.
At the heart of the Aledade model is the simple, but radical, idea that Aledade only succeeds when partner practices succeed in delivering better care at a lower cost. For more information, visit www.aledade.com. Aledade is a registered trademark of Aledade, Inc.
- Back -