Blue Cross and Blue Shield of Texas and Southwestern Health Resources Announce Accountable Care Organization (ACO) Agreement

Accountable Care Organization will provide access to high-quality, value-based care

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Oct 16, 2018, 10:00 ET

RICHARDSON, Texas, Oct.16, 2018 /PRNewswire/ -- Blue Cross and Blue Shield of Texas (BCBSTX) and Southwestern Health Resources have joined forces to provide access to high-quality and lower cost care. This includes services and enhanced coordination of care for more than 130,000 BCBSTX members across North Texas.

"We are excited about our collaboration with Southwestern Health Resources and its Southwestern Health Resources Accountable Care Network," said Dan McCoy, MD, president of Blue Cross and Blue Shield of Texas. "The agreement further affirms our commitment to population health and a coordinated-care model that ensures high-quality care and at a reasonable cost for our members and their patients."

The agreement, which was effective July 1, 2018, provides access to the Southwestern Health Resources Accountable Care Network (ACN), a clinically integrated network established by Texas Health Resources and UT Southwestern Medical Center. This includes doctors and caregivers, hospitals, outpatient facilities, surgery centers, behavioral health programs and imaging centers located throughout North Texas, along with the analytics and resources available through the Southwestern Health Resources Population Health Services Company.

"Our integrated network is based on collaborations and improving the consumer experience by providing better coordinated care," said Barclay Berdan, co-chair of Southwestern Health Resources and CEO of Texas Health Resources. "Simply put, our goal is to drive improvements that make heath care in North Texas more effective and efficient."

"Southwestern Health Resources has shown its ability to apply innovative and comprehensive patient-focused navigation strategies to achieve great outcomes as an Accountable Care Organization to the benefit of the communities of North Texas. Our clinically integrated network brings its experience in improving patient outcomes while lowering healthcare cost, to our new partnership Blue Cross and Blue Shield of Texas," said Daniel K. Podolsky, M.D., co-chair of Southwestern Health Resources, and President of UT Southwestern Medical Center.

An accountable care organization (ACO) is a healthcare collaboration that ties payments to quality measures and the cost of care. ACOs are formed by a group of providers that are committed to being accountable to patients and payers for the quality, appropriateness and efficiency of healthcare services that are delivered. ACOs involve doctors, hospitals, health plans, post-acute care facilities and others working together to make sure patients receive the right care at the right time and at the right cost.

About Blue Cross and Blue Shield of Texas
Blue Cross and Blue Shield of Texas (BCBSTX) – the only statewide, customer-owned health insurer in Texas – is the largest provider of health benefits in the state, working with nearly 80,000 physicians and healthcare practitioners, and 500 hospitals to serve more than 5 million members in all 254 counties. BCBSTX is a Division of Health Care Service Corporation (HCSC) (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the country's largest customer-owned health insurer, and fourth largest health insurer overall. Health Care Service Corporation is a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.

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About Southwestern Health Resources
Southwestern Health Resources is the clinically integrated network formed in 2016 by Texas Health Resources and UT Southwestern Medical Center to better serve North Texas residents. It blends the strengths of one of the nation's preeminent academic medical centers and one of the largest faith-based, nonprofit health care delivery systems in the United States. The Southwestern Health network consists of 30 hospital locations, as well as an expansive network of about 4,000 physicians and caregivers to provide higher value and easier access to all levels of care, from primary prevention to advanced specialized care. The network serves more than 7 million people across 16 counties in North Texas.

Physician-driven strategies are the foundation of the Southwestern Health Resources' achievements. As an example, an advanced shared health information exchange provides access across the network to data and analytics from millions of patient records. This includes previous conditions, treatments, prescriptions, care management, and other facts. With this information, physicians have increased opportunities to reduce inefficiencies, and ultimately, improve clinical results for patients.

The ACO has demonstrated its success, including the most recent performance results released by CMS for its Medicare Shared Savings Program, where Southwestern Health Resources ranks number 6 in the United States, out of more than 500 Accountable Care Organizations. This is based on designing and implementing a comprehensive patient-focused navigation strategies that saved CMS more than $73 million over three years, while maintaining a quality score in the 95 percentile.

Southwesternhealth.com

SOURCE Blue Cross and Blue Shield of Texas