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BCBSAZ Shared Savings Program Reduces Hospital Readmissions by 26%

BlueCross BlueShield of Arizona’s shared savings program reduced hospital readmissions by 26 percent and improved patient outcomes in other performance categories.

Source: Thinkstock

By Thomas Beaton

- BlueCross BlueShield of Arizona’s (BCBSAZ) shared savings program has reduced 30-day hospital readmission rates by 26.3 percent while generating shared savings for providers..

BCBSAZ also reported 15.2 percent fewer ED visits per thousand patients, as well as a 28.1 reduction in all-cause readmissions, as a result of the value-based care initiative

The payer reimbursed participating providers $1 million in extra payments after they exceeded care quality and patient outcome goals.  

BCBSAZ launched the shared savings program in 2016 with ACO Partner, a Change Healthcare company, and enrolled 603 providers into the model. Providers were responsible for 41,000 beneficiaries in total and lowered overall cost trends by 3.7 percent from 2016 to 2017.

John Wallace, senior vice president at Change Healthcare and COO of ACO Partner, explained that the shared savings program produces beneficial results for payers and providers, but is ultimately designed to improve beneficiary outcomes.

“The model deployed in Arizona, with a focus on care coordination and provider engagement, is achieving the value-based care goals we set when we launched. The program is working for providers and payers, but most importantly for members,” said Wallace. “The shared savings are just one metric, but when you look at the full range of cost and quality measures tracked through the program, you see that it's creating more primary care access, and better overall healthcare for members.”

Wallace previously explained that it took years to effectively engage providers in the shared savings program. The payer was able align business needs of both providers and BCBSAZ through meetings and discussions that educated physicians about the program.

“We made the investments and took on the responsibility of really assisting the staff and the doctors,” he told HealthPayerIntellgeince.com. “We were educating these providers with available clinical data about which patients we knew needed to be measured, based on the metrics that we set forward.”

The latest results of the shared savings program encouraged BCBSAZ leaders about the potential of other pay-for-performance programs to effectively reduce costs and improve healthcare outcomes.

“With this program, we set out ambitious goals for improving healthcare,” Dr. Woodrow Myers, Chief Medical Officer at BCBSAZ said in the press release.

“We wanted to outperform quality benchmarks and significantly reduce admissions and readmissions among our member population. The ACO Partner program’s success is critical for us to achieve our goal of creating a healthier Arizona.”

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