ACO Savings Go Back to Employers and Providers

Dec. 12, 2019

Blue Cross and Blue Shield of Texas’ (BCBSTX) Accountable Care Organizations (ACOs) have had almost $86.9 million in total savings which directly benefits employers and providers in Texas.

Employer groups generally see 50% of the savings reflected in their health insurance rates. Providers receive the other 50%, which allows them to invest more in delivering quality care. BCBSTX started our ACOs in 2015 and they have grown to more than 1 million members. We have 27 ACOs that include primary care providers in 90 counties.

The ACOs have a physician-centric strategy where they receive incentives to improve the care experience for members. If ACOs meet or exceed certain targets related to patient health outcomes, they get savings or incentives. Reducing costs while improving care is crucial and through collaboration, everyone in an ACO benefits from avoiding duplicate services and waste. Patients are less likely to miss any tests or immunizations and are more likely to go to their primary care visits. For members within ACOs, we have seen fewer emergency room visits and outpatient visits than members not in an ACO. This means more Texans are getting better quality care.

ACO savings can be reinvested to improve the quality of care for members, save on health care costs and shift care from treating symptoms to preventing illnesses.

Value-based care programs are the future as we continue to innovate and collaborate to provide better, less costly care for our members. For more information, check out the Dallas Business Journal1 and this Blue Promise.

 

1 McClure. S (2019, November 7)