Lee Sacks, MD, CMO of Oak Brook, Ill.-based Advocate Health Care, said the system's accountable care organization not only makes economic sense, but is "the right thing to do," according to a New York Times report.
The system launched its ACO, called AdvocateCare, in late 2010 with Blue Cross Blue Shield of Illinois. Based on data from the ACO's first six months, hospital admissions per member have decreased by about 10 percent and emergency department visits have fallen by 5 percent.
Under the ACO, which is one of the largest commercial models in the country, care managers frequently call to check on patients. They offer advice on diet and exercise, help schedule appointments, make arrangements with social workers and order meals for delivery.
"A care manager may care for up to 150 patients, and the savings from keeping those patients healthy, and potentially out of the hospital, pays for their salary several times over," Dr. Sacks said in the report.
"ACOs are coming, and it will change the way we pay for health care," Michael Cryer, MD, national medical director for Chicago-based consulting firm Aon Hewitt, said in the report. "Providers are doing things in a positive way rather than a reactive way. We are seeing the beginnings of a tsunami."
Despite AdvocateCare's early success and growing enthusiasm for the model, many healthcare providers and experts remain wary of its resemblance to an HMO and potentially high administrative costs.
Joseph Golbus, MD, president of Evanston, Ill.-based NorthShore University HealthSystem Medical Group, said ACOs shouldn't veer down the same path of the 1990's managed care. "What I think killed the HMO in the '90s was limiting access to patients and telling the [physician] he is now worth 17 cents per member, per month. We don't want to see that again," he said in the report.
10 Evolving Issues for Hospitals, Health Systems, Physicians & ACOs
NEJM: How Will ACOs "Keep Score" of Physicians' Pay?
The system launched its ACO, called AdvocateCare, in late 2010 with Blue Cross Blue Shield of Illinois. Based on data from the ACO's first six months, hospital admissions per member have decreased by about 10 percent and emergency department visits have fallen by 5 percent.
Under the ACO, which is one of the largest commercial models in the country, care managers frequently call to check on patients. They offer advice on diet and exercise, help schedule appointments, make arrangements with social workers and order meals for delivery.
"A care manager may care for up to 150 patients, and the savings from keeping those patients healthy, and potentially out of the hospital, pays for their salary several times over," Dr. Sacks said in the report.
"ACOs are coming, and it will change the way we pay for health care," Michael Cryer, MD, national medical director for Chicago-based consulting firm Aon Hewitt, said in the report. "Providers are doing things in a positive way rather than a reactive way. We are seeing the beginnings of a tsunami."
Despite AdvocateCare's early success and growing enthusiasm for the model, many healthcare providers and experts remain wary of its resemblance to an HMO and potentially high administrative costs.
Joseph Golbus, MD, president of Evanston, Ill.-based NorthShore University HealthSystem Medical Group, said ACOs shouldn't veer down the same path of the 1990's managed care. "What I think killed the HMO in the '90s was limiting access to patients and telling the [physician] he is now worth 17 cents per member, per month. We don't want to see that again," he said in the report.
More Articles on ACOs:
Survey: Majority of Healthcare Organizations Don't Intend to Become Medicare ACOs10 Evolving Issues for Hospitals, Health Systems, Physicians & ACOs
NEJM: How Will ACOs "Keep Score" of Physicians' Pay?