Highmark Announces Accountable Care Alliance

Margaret Dick Tocknell, for HealthLeaders Media , July 19, 2013

Highmark has already signed up 500 physicians employed by the Allegheny Health Network, an integrated delivery system that includes six hospitals. It plans to expand the program to physicians at Saint Vincent Health System in Erie, which Highmark acquired last week, by the end of the year. Officials said they expect the ACA to grow to include independent physicians throughout its central and western Pennsylvania markets, as well as its Delaware and West Virginia markets.  

For now the focus is on primary care physicians but specialists will be added at a later date. Paul Kaplan, MD, Highmark's senior vice president for provider strategy and integration, said Highmark is looking for physician groups where "someone is willing to be a champion for the new delivery system [who] understands the investment in time required to understand what their patients want, as well as the investment in IT and infomatics infrastructure needed."

Highmark officials declined to reveal how much the giant Blue Cross Blue Shield affiliate intends to invest in the alliance. Some funding for care coordination mangers will be included for selected physician groups to enable physicians to spend more time with costly chronically ill patients such as diabetics.  

"We're hoping to create a 'wow' factor for our patients," said Kaplan. "When they leave their doctor's office we what them to feel like they got what they needed, when they needed it, and at the right price."  


Margaret Dick Tocknell is a reporter/editor with HealthLeaders Media.
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