In Brief: Blue Shield Starts Inland Empire ACO

Blue Shield Launches ACO In Inland Empire

San Francisco-based Blue Shield of California has launched an accountable care organization in the Inland Empire.

The two-year initiative will be in conjunction with Redlands-based EPIC Management LP, which manages a variety of medical groups in San Bernardino and Riverside Counties. 

Six medical groups will participate in the ACO – Beaver Medical Group, Pinnacle Medical Group, Redlands-Yucaipa Medical Group, Alliance Desert Physicians, Tri Valley Medical Group

and Chaffey Medical Group – and will include 27,300 patients. 

Of those patients, about 7,500 are employed by San Bernardino County, and 7,000 are state employees or retirees whose benefits are provided by the California Public Employees Retirement System. All are enrolled in Blue Shield health maintenance organization plans.

The ACO will focus on eliminating unnecessary care and improving health outcomes for those participating in the program.

The ACO is Blue Shield's 11th in California and the first in the Inland Empire.

"We are very pleased to be collaborating with EPIC on our first ACO in the Inland Empire," said Kristen Miranda, Blue Shield's vice president of strategic partnerships and innovation. "This coordinated care model is proving successful in a variety of markets across the state and we look forward to bringing our best practices to this work with EPIC to improve patient care and reduce healthcare costs."

Kaiser Gets Top Score In Power Survey

Kaiser Foundation Health Plans in California scored highest in the annual J.D. Power health plan study for the seventh consecutive year.

“Meeting the needs of our members is our constant focus,” said Wade J. Overgaard, a Kaiser senior vice president in charge of its health plan operations in California. “We believe that our ability to make it easy for members to access high-quality care when and how they want it has enabled Kaiser Permanente to rank highest in customer satisfaction in the J.D. Power study of health plans in California.”

Kaiser received an overall score of 756 out of 1,000 points. Its score was so comparatively high that the six other health plans surveyed all scored well below the overall average of 680 points. Cigna came the closest, scoring 674 points, with UnitedHealthcare, Aetna, Health Net and Anthem Blue Cross scoring 650 and 667 points. San Francisco-based Blue Shield of California had the lowest satisfaction score of 639 points. 

Kaiser's California score was only outmatched by its score in the South Atlantic region of the U.S., where it received 784 points. Kaiser plans also had the highest satisfaction scores in Colorado, the Northwestern U.S., and the mid-Atlantic region.

The J.D. Power study was conducted from December 2013 to January 2014 and surveyed more than 34,000 enrolles in 138 commercial health plans throughout the U.S. It focused on six factors: coverage and benefits; provider choice; information and communication; claims processing; cost; and customer service. 

J.D. Power officials said that health plans need to better focus on quickly communicating with enrollees about care access and cost of care.