“In collaboration with providers, we are working together to transform health care in Iowa from a system that has emphasized quantity of care to one that rewards quality of care while also improving the patient experience.” said Sheryl Terlouw, director, network innovation. “This is a good indication of the positive results that can be achieved when providers of care and Wellmark work together with a common focus on the patient.”
ACOs are designed to improve the quality of care, provide greater value and slow increases in health care costs. ACO providers assume responsibility for managing a population of patients, both who are healthy and those who are in need of care, no matter where in the system the patients receive care. Wellmark offers the providers financial rewards if they reach established quality goals and slow the rate of increase in health care spending for these patients. At the same time, providers will not earn their incentives if their quality declines or their costs run higher than expected.
The ACO data being reported includes UnityPoint Health, Mercy Medical Center – Des Moines, Genesis Health Systems, Wheaton Franciscan Healthcare and a collaboration between Mercy Medical Center – Cedar Rapids and University of Iowa Hospitals and Clinics.
The five ACOs participating in 2013, which represent more than 358,000 members, achieved savings through reducing hospital admissions by nearly 12 percent, readmissions by 7 percent and emergency department visits by nearly 11 percent.
To date, ACOs have been comprised of members with fully-insured health insurance plans. In addition to the five ACOs listed above, Wellmark began ACO Shared Savings relationships in 2014 with Family Health Care of Siouxland, McFarland Clinic and The Iowa Clinic.
