An Example Of ACO Deals Going Small And Local

Until recently, ACOs have largely focused on creating large, sprawling structures linking giant providers together across multiple states. However, a news item that popped up on my radar screen reminded me that providers are quietly striking smaller local deals with hospitals and insurance companies as well.

In this case, cardiologists in Tupelo have begun to collaborate with Blue Cross & Blue Shield of Mississippi. Specifically, Cardiology Associates of North Mississippi will with Blue plan associate Magellan Health to create Accountable Cardiac Care of Mississippi.

It’s easy to see why the two agreed to the deal. The cardiology group has outpatient clinics across a wide region, including centers in Tupelo, Starkville, Columbus, Oxford and Corinth, along with a hospital practice at North Mississippi Medical Center-Tupelo. That offers a nice range of coverage for the health plan by a much sought-after specialty.

Meanwhile, the cardiology group should get a great deal of help with using data mining to deliver more cost-effective care. Its new partner, Magellan Health, specializes in managing complex conditions using data analytics. “We think we have been practicing this way all along, [but] this will allow us to confirm it,” said Dr. Roger Williams, Cardiology Associates’ president.

Williams told the News Leader that the deal will help his group improve its performance and manage costs. So far it’s been difficult to dig into data which he can use to support these goals. “It’s hard for us as physicians to monitor data,” he told the paper.

The goals of the collaboration with Blue Cross include early diagnosis of conditions and management of patient risk factors. The new payment model the ACO partners are using will offer the cardiology practices bonuses for keeping people healthy and out of expensive ED and hospital settings. Blue Cross and the Accountable Cardiac Care entity will share savings generated by the program.

To address key patient health concerns, Cardiology Associates plans to use both case managers and a Chronic Care program to monitor less stable patients more closely between doctor visits. This tracking program includes protocols which will send out text messages asking questions that detect early warning signs.  The group’s EMR then flags patients who need a case management check-in.

What makes this neat is that the cardiologists won’t be in the dark about how these strategies have worked. Magellan will analyze group data which will measure how effective these interventions have been for the Blue Cross population. Seems like a good idea. I’d suggest that more should follow this ACO’s lead.

About the author

Anne Zieger

Anne Zieger

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.