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Everett Clinic, Group Health to launch Medicare ACO

The Everett Clinic and member-owned healthcare co-op Group Health Cooperative announced this week they would strengthen their existing relationship through an alliance that will create an accountable care organization to serve seniors in Group Health's Medicare Advantage plan.

The program, which will focus on patients in Washington's Snohomish county, builds on a collaboration between the two organizations started in 2010 focused on care coordination. Under this arrangement The Everett Clinic already offers Group Health's ClearCare Medicare Advantage plan and the two also exchange electronic medical records.

According to the two companies, the new arrangement moves the two companies into a broader collaboration surrounding new specific strategic initiative that will help prepare them for changes in how care is delivered and to meet new standards of care.

Joint patient-centered initiatives include:

  • Development of a commercial accountable care organization – an organized network of providers accountable for delivering seamless, coordinated care at the local level and potentially in a larger geographic market.
  • Advancing the organizations' existing care quality initiatives for Medicare enrollees.
  • Collaboration to identify joint clinical programs to improve quality and reduce cost.
  • Identifying innovative ways within the healthcare delivery system to help patients avoid unnecessary ER visits and hospital admissions.

"Group Health and The Everett Clinic share a deep commitment to our patients and this agreement represents our commitment to the long-term health of our communities," said Scott Armstrong, president and CEO of Group Health, in a press release. "By drawing on the strengths and capabilities of our organizations, and through new models of payment to providers, our integrated physician organization will achieve three goals – enhance patient health, improve the patient care experience and decrease the overall cost of care."

The announcement is the latest development for The Everett Clinic as it actively works to find partners in its drive to recreate how care is delivered and paid for. Since 2010, along with Seattle-based The Polyclinic, it has been engaged with Premera Blue Cross in executing Premera's Global Outcomes contracting model, which stays rooted in fee-for-service while slowly moving to outcomes-based payments via care and quality incentives.

It was also one of ten physician groups chosen in 2005 to participate in the Physician Group Practice (PGP) Demonstration Project initiated by the Centers for Medicare & Medicaid Services. The five-year PGP project was designed to help practices develop preventive care models and methods of delivering chronic disease care and management for Medicare patients that deliver better outcomes at lower costs. Through the program, The Everett Clinic saved the Medicare program more than $2 million by developing these new care coordinated care models.

"Our patients will benefit because our organizations have a shared vision for the need to provide better care at a lower cost," says Everett Clinic resident Harold Dash, MD, in a statement about the alliance with Group Health. "This is a great opportunity to address the current and future challenges of healthcare together."

The Everett Clinic currently provides care for roughly 4,750 Group Health members. Group Health has 56,600 total members residing in Snohomish County, but under the new program patients from each organization will continue to see their current care-givers.

Both organizations will remain independent, though it is anticipated they will look to form a separate Limited Liability Company (LLC) through which they will work together as an ACO.

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