The New America Foundation has published an article about the unique partnership between Catholic Healthcare West, Hill Physicians, and Blue Shield of California to improve the efficiency of care for CalPERS members in Northern California.
Over the course of the past year, CalPERS has partnered with Blue Shield of California, Catholic Healthcare West and Hill Physicians Medical Group to pilot a new “virtual integrated delivery system.” CalPERS members who are covered through the Blue Shield of California HMO and who already had a doctor in the Hill Physicians Medical Group as their primary care physician were automatically enrolled in the program.
What are the terms of the deal? The insurer, hospital system and physicians association are given mostly free rein to redesign their care delivery systems to promote better coordination and improve efficiency. For example, these partners are eliminating redundancies such as having the same patient participate in multiple chronic disease management programs. In return for this autonomy, Blue Shield will not be raising premiums this year for over 40,000 CalPERS members who are participating in the pilot. What this means is that the insurer and providers have a strong financial motivation to produce the efficiencies they seek as they are on the hook to pay for any increase in costs.
As California’s largest private hospital provider and as an organization long committed to creating a more just health system, CHW is proud to participate in this pilot. We all have a responsibility to do what we can to make health care more accessible and affordable.
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