Great River Health Systems and Wellmark announce Accountable Care Organization agreement

Great River Health System and Wellmark Blue Cross and Blue Shield have announced a collaboration to engage in Wellmark’s Accountable Care Organization (ACO) program. The new collaboration will focus on coordinating patient care to improve quality, provide greater value and slow the rate of increase in health care costs.

“We’ve looked at several ACO programs over the past year, and we believe Wellmark’s program will help us to continue to provide high-quality care while saving valuable health care dollars,” said Mark Richardson, Great River Health System’ president and CEO. “The collaboration between our organizations will help our patients stay healthier and reduce the rate of increase in health care costs."

In an ACO, health care providers assume responsibility for managing a population of members, both who are healthy and those needing care, wherever in the system the member receives care. Wellmark offers providers financial rewards if they reach established quality goals and slow the rate of increase in patient-care costs. Providers will not earn financial benefits if their quality declines or their costs run higher than expected.

Great River Health System physicians will continue to treat their patients, and patients automatically receive the benefits of the ACO program at no additional cost. Health care providers most likely to see immediate ACO benefits are those who manage chronic conditions, such as diabetes, high blood pressure and obesity.

The ACO also will enhance care provided by Great River Health System by:

  • Allowing patients the continued freedom to see the providers of their choice
  • Encouraging patients to take active roles in their health care
  • Reducing unnecessary and redundant care and services

Great River Health System is one of 13 ACOs collaborating with Wellmark in Iowa. Wellmark and the ACOs serve more than 530,000 Wellmark members and include more than 2,000 physicians. Wellmark recently announced that its first five ACO collaborations saved more than $12 million during their first two years. In addition, they reduced hospital visits by 12 percent, readmissions by 7 percent and emergency department visits by nearly 11 percent. A complete list of the ACOs engaged with Wellmark is available on Wellmark.com.