Pittsburgh-based insurer Highmark Health Services is creating an accountable care network as the next step in an ambitious and nationally watched move into healthcare delivery.
The Blue Cross and Blue Shield affiliate likened its model to an accountable care organization, rewarding physicians for efficient and effective patient-centric care and quality outcomes.
After a long and tumultuous courtship and regulatory vetting, Highmark acquired West Penn Allegheny Health System last year and has formed Allegheny Health Network to include West Penn along with several other provider acquisitions. This year Highmark acquired Jefferson Regional Medical Center in Jefferson Hills, Pa., and St. Vincent Health System in Erie, Pa.
Physicians from six hospitals in the Allegheny Health Network—Allegheny General Hospital and Western Pennsylvania Hospital, both Pittsburgh; Allegheny Valley Hospital, Natrona Heights, Pa.; Canonsburg (Pa.) General Hospital; Forbes Regional Hospital, Monroeville, Pa.; and Jefferson Regional—will initially participate in the alliance, which will eventually include other Western Pennsylvania physicians and hospitals served by the insurer. St. Vincent, which already participates in a patient-centered medical home program, is likely to join the accountable care alliance next year.
“We need to be paying for value and not just volume,” Mike Fiaschetti, president of health markets for Highmark Health Services, said in a release. “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 alliance includes about 500 primary-care physicians who will be evaluated on 28 quality and outcome measures. As it evolves, Highmark plans to add specialists, as well as expand it to the entire Highmark service area, which includes West Virginia and Delaware.
Follow Rachel Landen on Twitter: @MHrlanden
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.
