Blue Shield of California and Leading Healthcare Providers to Collaborate on Coordinated Care Model That Ensures No 2011-2012 Rate Increase for City and County of San Francisco

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Mar 02, 2011, 02:00 ET

SAN FRANCISCO, March 2, 2011 /PRNewswire-USNewswire/ -- Blue Shield of California and five major healthcare providers today announced two new accountable care initiatives designed to provide integrated, cost-efficient health care to 26,000 employees, dependents, and retirees who are HMO members of the San Francisco Health Service System (HSS). Blue Shield is partnering with Brown & Toland Physicians Group and California Pacific Medical Center (a Sutter Health affiliate) for the integrated care of 21,000 HSS members assigned to Brown & Toland physicians, and with Hill Physicians Medical Group, Catholic Healthcare West, and the University of California, San Francisco for the care of 5,000 HSS members assigned to Hill Physicians Medical Group. As a result of these collaborations, San Francisco HSS members will receive no premium increase in 2011-2012.

The organizations will identify and implement long term strategies aimed at improving quality and efficiency to ensure that health care stays affordable for HSS members and local government employers: the City and County of San Francisco, the San Francisco Superior Courts, the San Francisco Unified School District and City College of San Francisco. The healthcare entities will partner to share clinical and case management information and coordinate comprehensive healthcare services for HSS members who choose the Blue Shield HMO. The organizations' incentives will be aligned to improve healthcare quality and patient service while reducing costs.

Both initiatives launch on July 1, 2011 and will continue for a minimum of 12 months, although it is the parties' collective intent that these collaborations will be long term and will continue to have a material impact on healthcare costs for HSS members and employers over time. The goal is to build a delivery model that improves quality through better coordination of care while taking costs out of the healthcare delivery system.

The collaborations involve eight major San Francisco hospitals: California Pacific Medical Center's four campuses (California, Davies, Pacific and St. Luke's), CHW's Saint Francis Memorial Hospital and St. Mary's Medical Center, and UCSF's two main facilities at Parnassus and Mount Zion.

"These collaborations among San Francisco's largest medical providers is an innovative undertaking to ensure that the City and County of San Francisco can continue to provide outstanding, cost-effective care for our employees, retirees and their families," said Supervisor Carmen Chu, Chair of the Budget & Finance Committee and Commissioner of the Health Service board.

"We need to take bold steps to transform how we provide and pay for care to make health coverage more affordable," said Jeff Hermosillo, vice president and general manager, labor, public and strategic accounts, Blue Shield of California. "We're delighted to partner with the Bay Area's top hospitals and medical groups to deliver high-quality care to HSS members with no premium increase next year."

Warren Browner, M.D., M.P.H., chief executive officer of California Pacific Medical Center, and Richard Fish, chief executive officer of Brown & Toland, indicated that their organizations, which in 2010 developed an enhanced network relationship, share Blue Shield's enthusiasm.

"CPMC and Brown & Toland are excited to be part of an undertaking with Blue Shield and the other providers. Health care is perhaps more challenging than it has ever been in this nation's history. This relationship will not only make health care more affordable for City employees, retirees and dependents, but will also better manage the care they receive," reported Dr. Browner.

"We have all worked together to hold down premium costs," said Fish. "However, this is about much more than not increasing a premium. This collaborative group will be developing specific initiatives to reduce hospital readmissions and improve patient wellness – all with the goal of improving quality and efficiency and ensuring affordability over the long term. We couldn't be more pleased to be part of this important endeavor."

"The agreement among Hill Physicians, CHW and UCSF creates an operational framework for an accountable care organization. This is an exciting example of how independent doctors, community hospitals and an academic medical center can collaborate to improve services and lower costs," said Steve McDermott, CEO of Hill Physicians Medical Group. "It allows for a more seamless member experience, from prevention and wellness, through hospitalization and a return to home and work."

"CHW is pleased to once again be partnering with Blue Shield and Hill Physicians as we extend to San Francisco residents the success we have seen with our accountable care program in Sacramento," said Bill Hunt, executive vice president/chief operating officer for Catholic Healthcare West. "As California's largest private hospital provider and as an organization long committed to creating a more just health system, we are committed to do what we can to make health care more accessible and affordable."

"UCSF is pleased to join CHW, Hill Physicians and Blue Shield in better coordinating care for city and county employees. Individually, our organizations each bring unique strengths to the relationship. Together, we can create a structure that puts patients in the center and provides them with high-quality, cost-effective care, regardless of their need," said Jay Harris, chief strategic planning officer, UCSF Medical Center.

Employees, retirees and dependents of the HSS will be able to choose their health plan during the annual open enrollment period in April 2011.

About the San Francisco Health Service System

Since 1944, San Francisco has provided health coverage for its employees. The Health Service System, governed by a board elected by its members and appointed by the Mayor and Board of Supervisors, is responsible for health and other benefits for nearly 110,000 employee and retiree members and their dependents.

About Blue Shield of California

Blue Shield of California, an independent member of the Blue Cross Blue Shield Association, is a not-for-profit health plan with 3.3 million members, 4,800 employees, and one of the largest provider networks in California. Founded in 1939 and headquartered in San Francisco, Blue Shield of California offers a wide range of commercial and government products throughout the state. The company has contributed more than $125 million over the past four years to the Blue Shield of California Foundation—which was named one of BusinessWeek's 20 most generous corporate foundations. For additional information, visit www.blueshieldca.com.

About Brown & Toland Physicians

Brown & Toland is one of California's largest and most successful physician networks. A leader in providing innovative technological solutions for its physicians, Brown & Toland has earned numerous awards for quality of care and disease management. Brown & Toland has more than 800 physicians caring for 300,000 HMO and PPO patients. For additional information, visit www.brownandtoland.com.

About California Pacific Medical Center

At San Francisco's California Pacific Medical Center, we believe in the power of medicine. We research the most up-to-date treatments, hire the most qualified individuals, and practice the most modern, innovative medicine available. We deliver the highest quality expert care, with kindness and compassion, in acute, post-acute and outpatient services, as well as preventive and complementary medicine. But we also believe that medicine alone is only part of the solution. That's why we look intently at each individual case and treat the whole person, not just the illness. It's why we go beyond medical care and provide our patients with things like disease counseling, family support and wellness treatments. As one of California's largest private, community-based, not-for-profit, teaching medical centers, and a Sutter Health affiliate, we are able to reach deep into our community to provide education, screening and financial support in some of the city's most underserved neighborhoods. Medicine can transform a body. But going beyond medicine can transform a life. www.cpmc.org

About Catholic Healthcare West

St. Mary's Medical Center and Saint Francis Memorial Hospital are members of Catholic Healthcare West (CHW), the eighth largest hospital system in the nation and the largest not-for-profit hospital provider in the West. Founded in 1986, the CHW network of more than 10,000 physicians and approximately 54,000 employees serve a population spanning 22 million people at 40 hospitals across California, Arizona, and Nevada. CHW is committed to delivering compassionate, high-quality, affordable healthcare services with special attention to the poor and underserved. In 2010, CHW provided $1.3 billion in charity care, community benefits, and unreimbursed patient care. For more information, please visit the CHW website at www.chwHEALTH.org.

About Hill Physicians Medical Group

Hill Physicians Medical Group is the largest independent physician association in Northern California and a recognized leader in innovative healthcare. The Integrated Healthcare Association and California Association of Physician Groups have recognized Hill Physicians as one of the top-performing medical groups in the state. Committed to serving healthy lifestyles, Hill Physicians Medical Group offers extensive health education services to its patients, including wellness classes, health screenings and self-help through its online information portal at www.HillPhysicians.com.

About University of California, San Francisco

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. http://www.ucsf.edu. UCSF Medical Center and UCSF Benioff Children's Hospital are world leaders in health care, known for innovative medicine, advanced technology and compassionate care. Our expertise covers virtually all specialties, including cancer, heart disease, infertility, neurological disorders, organ transplantation and orthopedics as well as special services for women and children. UCSF Medical Center has been ranked by U.S. News & World Report among the nation's top 10 premier hospitals for 10 consecutive years. http://www.ucsfhealth.org/