Blue Shield of California gives $20M in ACO help

Eighteen California hospitals, health systems, clinics and physician groups -- many of them catering to underserved populations -- will receive grants totaling nearly $20 million from Blue Shield of California to help them participate more effectively in accountable care organizations (ACOs).

The ACO grants are being made as part of Blue Shield's 2 percent pledge, a commitment the company made last June to limit annual net income to 2 percent of revenue and to return the difference collected above that amount to customers and the community. The grants, announced Oct 17, represent an average of $10 million for each of the two fiscal years (2010 and 2011) that the pledge has been applied.

Blue Shield currently participates in three ACOs in Sacramento and San Francisco covering 70,000 HMO members. It has plans for additional collaborations in Orange and Stanislaus counties aimed at delivering integrated, cost-efficient care to 38,000 members. ACOs are a key part of delivery system reforms included in the Affordable Care Act.

"We received nearly 60 grant applications from providers around the state,” said said Paul Markovich, executive vice president and chief operating officer, Blue Shield of California. “This demonstrates overwhelming interest among providers in collaborating to reduce costs and enhance the quality of care.
Markovich noted that among those receiving grants are a community clinic serving safety net populations, the largest independent Federally Qualified Health Center in the nation, several entities seeking to better manage patients with chronic diseases such as diabetes, and two children's hospitals.

AltaMed Health Services Corporation, which serves Latino, multi-ethnic and uninsured populations in Los Angeles and Orange Counties, will apply its $1 million grant to improve clinical integration with its Accountable Care Network hospital partners. "We thank Blue Shield of California for supporting our vision of improving access to care for the safety net population,” said Castulo de La Rocha, president and CEO of AltaMed. “This grant will greatly accelerate our ability to enhance continuity of care, manage post-discharge care of patients, and enhance coordination of care among the communities we serve."

See the next page for a list of the grantees, their awards and their plans.