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Excellus BlueCross BlueShield and St. Joseph’s Hospital Health Center Collaborate on Accountable Cost and Quality Arrangement

Excellus BlueCross BlueShield and St. Joseph’s Hospital Health Center today announced the formation of an innovative alliance designed to achieve enhanced care coordination, improve patient satisfaction and outcomes and reduce health care costs. 


The collaboration, known as an Accountable Cost and Quality Arrangement (ACQA), will benefit Excellus BlueCross BlueShield members who receive care from doctors affiliated with St. Joseph’s.


Using St. Joseph’s comprehensive, integrated system of physicians and ambulatory services, the collaboration will provide better health care options for patients by: 


·         Increasing physician-patient engagement to coordinate care and improve health care experience and outcomes,

·         Improving quality of care,

·         Aligning payment with quality, patient outcomes and value.


The goals of delivering better health care quality and avoiding unnecessary costs can be achieved through such efforts as improving access to primary care medical services (to manage chronic illnesses such as diabetes and reduce the need for emergency room visits), improving medication adherence rates and limiting duplication of services. 


“We’re excited to collaborate with St. Joseph’s on this new approach that redefines our relationship,” said Christopher Booth, chief executive officer, Excellus BlueCross BlueShield. “ACQAs emphasize value over volume. Incentives are based on quality of care; not volume of services. They strive to make everyone in the health care delivery system – patients, health care providers and health insurance companies – responsible stewards of health care dollars.”


According to Kathryn Ruscitto, president and chief executive officer of St. Joseph’s, “We believe this innovative arrangement provides an exciting opportunity to align the interests of the physicians in our system, the hospital and Excellus BlueCross BlueShield to improve community health while enhancing affordability.”


Providers must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe and timely. The ACQA assesses quality performance by using national quality measures, which include performance thresholds for diabetes, blood pressure and coronary artery disease, just to name a few.


The ACQA offers valuable opportunities for both organizations to bring together existing skills and resources to benefit the patient. The health plan provides extensive information and health analytics to assist St. Joseph’s in understanding cost drivers, quality performance and the health needs of the targeted population.


Excellus BlueCross BlueShield expects the number of members tied to some form of a value-based payment program such as an ACQA to increase dramatically by 2016. These types of innovative payment arrangements require no action on behalf of the member or his/her employer. Provider participation in an Excellus BlueCross BlueShield ACQA is voluntary. 


Excellus BlueCross BlueShield will continue to work with upstate New York providers to support the formation of additional ACQAs. “We are committed to the success of this program and realize that establishing new approaches for care delivery takes patience and time,” said Booth.


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Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.8 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools in our Step Up program. To learn more, visit ExcellusBCBS.com.


St. Joseph’s Hospital Health Center is a non-profit, 431-bed hospital and health care system in Syracuse, N.Y., providing services to patients in 16 counties in Central New York State. Through prevention programs and the latest diagnostic treatment procedures, St. Joseph's works with patients to achieve optimum long-term health. A 15-time winner of the National Research Corporation Consumer Choice award, St. Joseph’s is affiliated with Franciscan Companies and sponsored by the Sisters of St. Francis.