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ACO Momentum in Southern California

BY PATTI OLIVER –Blue Shield of California’s efforts to transform health care delivery and ensure high quality, coordinated care for members took another step forward in Southern California with this week’s announcement of a new ACO in the Inland Empire region.

In this latest collaboration, Blue Shield joins forces with PrimeCare Medical Network, Inc., the region’s largest network of independent contract physicians, and San Antonio Regional Hospital, which has served the community for 109 years.

Together, our goal is to improve the coordination and quality of care for area residents enrolled in Blue Shield’s HMO plans while helping to control costs and make healthcare sustainably affordable.

Over the past five years, Blue Shield has established more than 37 ACOs throughout California. The foundation of our collaborations is based on sharing important patient health data and clinical strategies so that providers involved in a patient’s care can support the same treatment plan and help manage healthcare costs efficiently.

A great example of how this type of collaboration can work is one of the features in our latest ACO – the new Complex Care Clinic operated and staffed by PrimeCare’s Hospitalist group at San Antonio Regional Hospital. Patients with complex-care needs, who are discharged from the hospital, are seen and managed at the clinic by the same physicians who took care of them during their hospital stay. Care managers and medical assistants round out the team to provide a heightened level of coordinated care to ease the transition out of the hospital, and help to reduce unscheduled returns to the emergency room or the hospital. Primary care physicians also have access to the patient’s data to continue caring for them after discharge.

Both PrimeCare and San Antonio Regional Hospital have long been recognized for the exceptional care they provide to the people and communities they serve. Through this new ACO collaboration, they will be able to further enhance that level of care, delivering better health outcomes and greater satisfaction for their Blue Shield patients.

Patti Oliver, R.N., is senior director of Clinical Program at Blue Shield of California


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