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March 12, 2015

DES MOINES, IA – Wellmark® Blue Cross® and Blue Shield® has expanded collaboration with four new Accountable Care Organizations (ACO) in Iowa in addition to continuing to engage with an existing group of ACOs working to improve the quality and cost of health care for patients. The new ACOs include Great River Health System, Mercy Iowa City, Nebraska Methodist Jennie Edmundson Hospital and Pella Regional Health Center.

ACOs are designed to improve the quality of care, provide greater value and slow increases in health care costs. In an ACO, providers assume responsibility for managing a population of members, both who are healthy and those who are in need of care, no matter where in the system the patients receive care. Wellmark offers the providers financial rewards if they reach established quality goals and slow the rate of increase in health care spending for these members. At the same time, providers will not earn their incentives if their quality declines or their costs run higher than expected.

“This new group of ACOs are being added to a solid foundation of ACOs that have proven that higher quality care truly saves valuable health care dollars,” said Mike Fay, Wellmark vice president of health networks. “We believe the coordination and collaboration with each of these organizations will help our members stay healthier, avoid unnecessary or duplicative tests, and reduce preventable hospital readmissions, and ultimately slow the rate of increase in health care costs."

Members will continue to be treated by their current physician and automatically receive the benefits of the ACO program at no additional cost. Members most likely to see the immediate benefits of the ACO are those who need help managing chronic conditions, such as diabetes, hypertension, and obesity.

Together, Wellmark’s 13 ACOs serve more than 525,000 Wellmark members and include over 2,000 personal doctors. Wellmark recently announced that its five initial ACO collaborations saved more than $12 million during their first two years. In addition, they reduced hospital visits by 12 percent, readmissions by 7 percent and emergency department visits by nearly 11 percent. A complete list of the ACOs engaged with Wellmark is available on Wellmark.com.