10 ACOs to Know

1. Advocate Health Care (Oakbrook, Ill.). Advocate partnered with Blue Cross and Blue Shield of Illinois in Oct. 2010 to form a three-year ACO. Advocate agreed to limit annual increases in return for the opportunity to share in savings resulting from its clinical integration programs. BCBSIL is the largest health insurer in the state, with nearly 7 million members, and Advocate operates more than 250 sites of care, including 10 acute-care hospitals.

2. Atlantic Health (Morristown, N.J.). Non-profit Atlantic Health formed an ACO in Dec. 2010. The system is comprised of two hospitals, and more than 300 physicians were already participating in the ACO program at the time of its announcement. The ACO serves a seven-county area in New Jersey. It expects its ACO to be ready to work with various populations, including Medicare patients, by Jan. 2012.

3. Carilion Clinic (Roanoke, Va.). Carilion announced its formation of an ACO in collaboration with Hartford, Conn.-based Aetna in March. The ACO will result in co-branded commercial healthcare plans for businesses and individuals, new payment models and shared cost savings, and joint opportunities to personalize care needs of patients, including Virginia's Medicaid beneficiaries. Aetna serves approximately 35.3 million people and Carilion serves nearly one million through its hospitals, outpatient specialty centers and advance primary care practices.

4. Catholic Healthcare West (San Francisco). Along with San Ramon, Calif.-based Hill Physicians and Blue Shield of California, CHW launched a program to manage the care of more than 40,000 members of the California Public Employees' Retirement System. The collaboration, which was announced in April 2009 and went live in Jan. 2010, essentially operates as an ACO. CalPERS members who already had a primary care physician affiliated with Hill were automatically enrolled in the program, which aims to improve what providers considered a "disjointed delivery system."

5. Doctors Medical Center (Modesto, Calif.). In June, Doctors Medical Center announced it will launch a three-year ACO with San Francisco-based Blue Shield of California and Modesto-based AllCare Independent Physician Association. The program will cover 8,000 HMO members and will go into effect Jan. 1. Preliminary work is already underway across the three organizations, and is expected to pick up speed in the coming months.

6. Franciscan Alliance (Mishawaka, Ind.). The 13-hospital system formed an ACO in Feb. 2010. Franciscan Alliance operates hospitals in both Illinois and Indiana and employs more than 550 physicians, with plans to expand its team to more than 630 physicians next year. The system took its first step towards ACO formation in late 2010 when it forged an agreement with Anthem Blue Cross and Blue Shield to provide patients enrolled in Hoosier Healthwise and the Healthy Indiana Plan with access to a more integrated system.

7. Methodist Health System (Dallas). In May, Methodist partnered with Texas Health Resources, based in Arlington, to develop a multi-provider ACO. Doug Hawthorne, CEO of Texas Health Resources, said the non-profit health systems both have strong faith-based foundations and are anchored in complementary locations. Prior to the announcement, the organizations had been participating in ACO preparatory projects with Premier, a national healthcare performance improvement alliance.

8. Norton Healthcare (Louisville, Ky.). In Nov. 2010, Norton partnered with insurer Humana, also based in Louisville, to create the first ACO in the Louisville area. Humana has approximately 10 million medical members, and non-profit Norton is comprised of five Louisville hospitals with nearly 2,300 total physicians on its medical staff. The ACO was launched as part of the Brookings-Dartmouth ACO Pilot Project.

9. OhioHealth (Columbus, Ohio). In June, OhioHealth announced its collaboration with Ohio-based health insurer Medical Mutual and the Medical Group of Ohio to form the Health4 program, which basically functions as an ACO. The 18-hospital system formed Health4 with MGO in 2009. The partnership focused on a clinically integrated pay-for-quality approach to healthcare. Now, through the partnership with an insurer, Health4 physicians and hospitals will be financially rewarded when quality measures are met and savings are realized.

10. ProHealth Care (Waukesha, Wis.). In Oct. 2010, ProHealth partnered with Waukesha Elmbrook Health Care, a local independent physician association, to form the first ACO in southeast Wisconsin. The ACO, called ProHealth Solutions, includes more than 475 WEHC physicians. Other participants include Waukesha Memorial Hospital, Oconomowoc Memorial Hospital and ProHealth's behaviorial health, home care and hospice facilities. 

Related Articles on ACOs:
5 Important Findings on ACOs
Accountable Care Organizations: What to Expect and How to Prepare
Analysis of Comments on ACOs Finds Certain Regulations Sparked More Concern Than Others

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