Change Healthcare and ACO Partner announced results for the first complete plan year of its novel shared savings program with Blue Cross Blue Shield of Arizona (BCBSAZ). Participating providers reported a 26.3% lower 30-day readmission rate and 28.1% lower all-cause readmission rate than their non-participant cohort. They also reported 20% fewer admissions and 15.2% fewer emergency department visits per thousand treated members. Participating providers also outperformed cohort in achievement of the program’s Quality Index by 2.7%, and drove lower specialty pharmacy spend, decreased imaging utilization, and more High-Efficiency Network (HEN) specialist referrals. Detailed metrics can be found in the accompanying infographic.
High-performing providers in the program were rewarded for progress toward achieving the “triple aim” of reducing costs, enhancing the patient experience, and improving population health. The providers’ level of performance is reflected across key cost and quality metrics relative to the non-participating cohort. Collectively, these and other cost and quality gains led to the Blue Cross Blue Shield of Arizona Shared Savings Program remitting a total of $1 million to 603 participating providers who treated over 41,500 members. Additionally, the program drove a risk-adjusted claims cost trend from 2016 to 2017 that was 3.7% lower than the cohort trend.