; Highmark Health Services Forms Accountable Care Alliance To Improve Care And Health Outcomes For Western Pennsylvania Residents
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Press Release

Highmark Health Services Forms Accountable Care Alliance To Improve Care And Health Outcomes For Western Pennsylvania Residents

July 18, 2013

PITTSBURGH — Highmark Health Services is helping to improve health care through the formation of the Accountable Care Alliance, designed to not only improve care, but to also make it more affordable for patients in western Pennsylvania. This collaboration with health care providers will improve the experience patients have when interacting with the Allegheny Health Network, improve the coordination of care and lower health care costs.

"On behalf of our individual members and employer groups, we are working to change the health care system to deliver more value for the health care dollar," said Mike Fiaschetti, president of health markets for Highmark Health Services. "We need to be paying for value and not just volume. This collaborative arrangement will lead the transition to a modernized and more efficient delivery system that offers the opportunity to improve quality and achieve better health outcomes for patients and improve the patient experience."

The Accountable Care Alliance will include Allegheny Health Network (AHN) physicians from six AHN hospitals, including:

  • Allegheny General Hospital
  • Allegheny Valley Hospital
  • Canonsburg Hospital
  • Forbes Hospital
  • Jefferson Hospital
  • West Penn Hospital

The Accountable Care Alliance will eventually include other physicians and hospitals from western Pennsylvania and other communities served by Highmark Health Services.

According to Tony Farah, M.D., AHN chief medical officer and president, Allegheny Clinic, the Accountable Care Alliance represents the future model of patient care management in the country as the health care industry moves away from traditional volume-based revenue incentives to those based on quality outcomes, prevention of disease and more efficient and effective patient-centered care.

A fundamental tenet of the alliance is improved coordination of care among providers, especially for people with chronic medical conditions. This coordination of care should result in greater certainty that patients are getting the right care at the right time and in the right setting.

The alliance is a major step in aligning health care providers of all kinds to work together in coordinated efforts to improve the quality, safety and efficiency of patient care. This collaboration will help transform health care delivery in ways that ultimately will help the work of doctors and hospitals — but first and foremost, the alliance will create a new level of quality care for patients.

The alliance will incorporate best medical practices, technology enhancements and lessons learned on how to best coordinate care to distribute relevant clinical information promptly to providers during the evaluation and treatment of patients.

"Our physicians, nurses and allied healthcare professionals look forward to collaborating with Highmark Health Services in this important endeavor and to playing critical roles in the establishment of new standards for how patient care quality and the ideal patient experience is defined," said Dr. Farah.

The Highmark Health Services Accountable Care Alliance will address long-overdue changes in the way providers are paid. The alliance will accelerate the movement to pay-for-value payment methods that align incentives to help improve quality and patient safety while encouraging delivery of the best possible care in the most appropriate setting — in contrast to the existing fee-for-service system, which pays providers according to the volume of medical services they provide.

The Saint Vincent Health System is currently participating with the patient-centered medical home program (PCMH) through Highmark Health Services. The PCMH model of providers assuming responsibility for the overall care of patients forms the core of the Accountable Care Alliance. It is likely that Saint Vincent will also join the alliance in 2014.

Akin to accountable care organizations (ACOs) that are forming in other markets to address concerns about quality, patient safety and cost, the Accountable Care Alliance of Highmark Health Services will emphasize greater teamwork among community primary care physicians, specialty physicians and health systems that join the alliance to better coordinate the overall care of patients.

Highmark Health Services
Highmark Health Services is among the largest health insurers in the United States and the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark Health Services operates health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.3 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark Health Services is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit www.highmark.com.

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 105 million members – one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit bcbs.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.