Advocate Health, Blue Cross of Illinois See Promising Results From ACO

Molly Gamble (Twitter) -
Oak Brook, Ill.-based Advocate Health Care says data from its accountable care organization with Blue Cross Blue Shield of Illinois suggests the model can reduce physician and hospital visits and high-cost services, according to a Kaiser Health News report.

Advocate and BCBS agreed to form the ACO — called AdvocateCare — in late 2010. To date, it has 250,000 PPO and 125,000 HMO members.

Reviews of the model are based on data from the first six months of 2011. In that time, AdvocateCare's hospital admissions per member decreased by 10.6 percent, and emergency department visits fell by 5.4 percent compared with 2010.

Many patients have delayed medical care due to the unstable economy, resulting in decreased utilization numbers for many healthcare providers. Still, Lois Elia, vice president of AdvocateCare, said the ACO influenced utilization rates as well.

"The economy impacted some of this," Ms. Elia said in the report. "But since our medical cost trend was 6.1 percent below market, it shows our reductions were likely due to prevention of ambulatory-sensitive conditions through better care management, physician access and the like."

While Ms. Elia said the statistics are encouraging, she made note that six months of data is still too little to draw conclusions about a three-year project.

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