Blue Shield of California Introduces Trio Product Built Around ACO Providers

New HMO product is designed to offer enhanced care coordination and improved patient experience at a markedly lower price for employers

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Blue Shield of California

Nov 04, 2014, 02:00 ET

SAN FRANCISCO, Nov. 4, 2014 /PRNewswire-USNewswire/ -- Blue Shield of California today announced the launch of Trio, a new HMO product which includes a network of healthcare providers that participate in the company's Accountable Care Organization (ACO) program. ACOs are collaborations in which doctors, hospitals and Blue Shield share responsibility for providing integrated care for patients in order to lower healthcare costs and enhance quality. ACOs improve patient care across the delivery system by ensuring members get the care they need in a timely and efficient manner while reducing unnecessary ER visits, hospitalizations and readmissions.

Trio was designed to:

Offer employers a lower cost HMO option – with premiums of 12-15 percent less than Blue Shield's traditional Access+ HMO product (depending on plan design) – enabling them to offer affordable healthcare coverage for their employees.
Provide members with access to high-quality, well-coordinated health care with their health plan, physician group/primary care physician and local, participating hospital(s) working together as an integrated team to ensure they get the care they need.
Deliver a long-term solution that will curb healthcare cost increases and year-over-year premium growth by putting Blue Shield's successful ACO model to work on a larger scale, with achieved savings contributing directly towards lower than expected premiums.

Since the early success of its first pilot arrangement with Hill Physicians and Dignity Health in the Sacramento market in 2010, Blue Shield's unique ACO program has grown to include 20 ACO collaborations with providers across the state, delivering coordinated care to more than 260,000 HMO members. The Blue Shield ACO model is one of the most successful in the country, having saved more than $250 million in healthcare costs since inception. This model improves information sharing and decision-making between providers, hospitals and Blue Shield as the three parties work together side-by-side under a set of aligned incentives.

"Trio provides access to high quality, affordable care that puts our members first. Their needs are the central focus for the three organizations involved in our ACO model: doctors, hospitals, and Blue Shield of California," said Janet Widmann, executive vice president at Blue Shield. "Our ACO providers have a strong track record of improving patient care. With this new product offering, employers can offer the Trio ACO HMO option alongside a traditional HMO or PPO plan from Blue Shield, giving their employees a lower cost option with an improved patient experience."

Trio is available to small and large group employers beginning on January 1, 2015, and includes access to a network of providers representing all specialties and levels of care in 16 California counties (Contra Costa, El Dorado, Kern, Los Angeles, Orange, Placer, Riverside, Sacramento, San Bernardino, San Diego, San Francisco, San Joaquin, Santa Clara, Santa Cruz, Stanislaus and Yolo). As with Blue Shield's standard HMO plans, Trio ACO HMO plan members are required to select a personal physician to coordinate and direct their healthcare needs. A current listing of physician groups participating in the Trio network is available here.

Trio brings Blue Shield's ACO model together with other enhanced services for members, including:

Shield Concierge: provides a personalized service experience for members through a one-stop-shop team to address their healthcare and coverage needs (i.e. assistance with benefits, finding doctors and specialists, and obtaining prescription drug authorizations). The Shield Concierge team includes customer service representatives, nurses, social workers, health coaches and pharmacists, and works closely with the ACO providers as needed. The program is also designed to proactively identify services which would be specifically beneficial to the member.
Wellvolution wellness platform: builds member engagement in their own health through a series of wellness programs that are fun and easy to fit into a busy lifestyle. Members connect through programs that blend increased physical activity with social gaming and rewards.

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 3.4 million members, 5,000 employees and $10.8 billion in annual revenue. Founded in 1939 and headquartered in San Francisco, Blue Shield of California provides health, life, dental, vision, and Medicare insurance and health care service plans in California. The company's mission is to ensure that all Californians have access to high-quality care at an affordable price. Blue Shield has contributed more than $325 million over the past ten years to the Blue Shield of California Foundation. Contact your local agent or broker about Blue Shield of California products and services, or visit www.blueshieldca.com.

MEDIA CONTACT:
Lindy Wagner
Corporate Communications Manager
[email protected]
415-229-6872

SOURCE Blue Shield of California