Larry Nall, senior vice president of provider network management for BCBS-TN, says the insurer was intrigued with MissionPoint's 2012 ACO announcement and has tracked its progress since.
"One of the things we've been doing is looking for strategic partners around the state," says Nall. "What we will do is make it available for self-funded employer groups as of Jan 1, 2014. As we continue the partnership, [we'll explore] how to make it available for other funding types. There are a lot of details to work out, but we picked the right partner."
Currently MissionPoint looks at 3-5 years of historical data as a starting point for care. Then it customizes a health plan with interventions designed to improve the health of its members, based on their medical conditions.
When the ACO option is rolled out to employers next year, MissionPoint and BCBS-TN, like other ACOs, will share claims and clinical data to determine the best path of care.
Dinger says employers get health information quarterly, or as needed, depending on the size of the employer group. He points to allied health partners his organization has added to the MissionPoint ACO as evidence the infrastructure exists to take care of the extra patients from BCBS-TN.
"We now have over 1,500 providers in our network throughout the middle Tennessee area," says Dinger. "We've also brought on a number of allied health and post acute care partners in the areas of durable medical equipment and skilled nursing facilities."