Although oncologists felt left on the sidelines when the government announced the final rule for Accountable Care Organizations, oncologists have taken matters into their own hands. A private insurer and a health system are teaming up to create the first cancer-specific ACO.
Florida Blue and Baptist Health South Florida are teaming up with oncology practice Advanced Medical Specialties to launch the new ACO in Florida. Since oncology has so many high costs, Florida Blue is focusing on it first, according to Health Leaders Media. However, the insurer ultimately wants to roll out multiple specialty-specific ACOs.
“Our focus has been on evidence-based treatment regimens, advance care planning, and the avoidance of unnecessary ER visits and hospital admissions,” Leonard Kalman, MD, chairman of Advanced Medical Specialties, said in a statement. “Our collaboration with two health care leaders, Florida Blue and Baptist Health, will spur innovation that will lead to better-coordinated, more cost-effective care of our patients with cancer.”
The ACO will focus on treating the most common forms of cancer in hopes that its success will lead to replications across Florida.
The cancer ACO will have to report performance on readmission rates, adherence to chemotherapy regimens, adherence to accepted to clinical guidelines and efficiency of care, among others, according to the Advisory Board Company.
The arrangement does not have to follow Medicare’s shared savings program, although it will probably mirror Medicare. Florida Blue hasn’t provided specifics on how the oncology ACO will be reimbursed. But since the ACO is not partnered with the government, it doesn’t have to follow requirements like including a primary care physician or maintaining a patient minimum.
“This is a collective effort between three health care industry leaders that will not only benefit our oncology patients first and foremost, but will also help set a new standard for top-quality care coordination,” said Ralph Lawson, executive vice president and chief financial officer for Baptist Health, in a statement.
First Cancer-Specific ACO Launches