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Blue @ Work

The future of health care is now

This Midwestern collaboration sets the standard for care innovation internationally

There’s a reason successful people rarely work alone. When we work together, it’s easier to bounce ideas off of each other, tackle problems from different angles, and even create a unique solution for a complex question.

Innovation takes many forms, and sometimes it comes by way of an interesting collaboration between seemingly unrelated groups. Case in point: 3M — a global science company, located in St. Paul, Minnesota, and produces a mind-boggling 55,000 different products. They are also the parent company of 3M Health Information Systems External Site, which emphasizes value-based care to transform the health care system. Wellmark Blue Cross and Blue Shield, an early adopter of value-based care programs, has access to a huge volume of data and leads the way in data analytics, or using data to inform decisions.

The two companies — Wellmark and 3M Health Information Systems — have been partners for more than a decade. Their most recent success, though, dates back to 2012, when they embarked on the biggest move in integrated care, the groundbreaking Accountable Care Organization (ACO) model.

Wellmark: Leading the way with ACOs

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An ACO, made of an exclusive network of doctors and hospitals, shares financial and medical responsibility for providing coordinated care to patients. The goal is to improve the health care experience and slow the rate of health care cost increases. In a nutshell, an ACO emphasizes the relationship between a member and their personal doctor while aiming to transform health care from a system that treats disease to one that improves health and well-being. ACOs want to keep healthy people healthy and improve the health of those seeking treatment.

These organizations also have unique payment models. Cost savings are shared with the ACOs and payments are linked to quality improvements that reduce the rate of health care cost increases. This encourages providers to deliver better care more efficiently. (There are no incentives to withhold medically necessary care.)

In 2012, Wellmark had three ACOs. Fast forward to late 2017, and that number has increased to 16. And all of them came to Wellmark — none were recruited.

The process wasn't easy. It took about a year to get the first three ACOs up and running. This included outlining key processes, meeting all the legal requirements, and finally, exchanging data and working out the kinks to really deliver the information they needed. Once this was in place and they started seeing the relevance of the data, other ACOs came to the table. These leading organizations realize that value — not volume or fee-for-service — is the future of health care.

Wellmark has seen a culture of change taking place over the past six years. Physician leadership has increased, quality and cost analytics have improved, and perhaps most important, ACOs have driven health care systems to share information. This transparency is truly changing the game.

ACOs in the global spotlight

This purposefully innovative model has been so successful, it’s gained international attention. 3M Health Information Systems is now using insights gained from their relationship with Wellmark on a global stage. In 2017, visitors from Europe — including economists and physicians from the United Kingdom, Spain, Belgium and Italy — traveled to Wellmark to learn more.

The group is part of a National Health Service effort to develop eight ACOs in the U.K. During their visit, the group learned that Europe and the Midwest have a lot in common. They learned insights about value-based health care and ACOs, and took away pointers for fighting a much smaller, but still developing, obesity epidemic in their home nations.

“The ACO approach Wellmark has taken is the first we know of to employ metrics for performance that are not disease specific, are population-based, and can be used for continuous quality improvement,”says Herb Filmore, senior director of market development, populations and payment solutions at 3M Health Information Systems. “Wellmark is also known for their collaborative approach with the ACO community. As the program matures, we value the contribution Wellmark and the provider community is making to build a better program. Key improvements have resulted from this process, including the entire way metrics about value are scaled and rated.”

“Another key take-away from our visit is Wellmark’s focus on sustainability,” says Mike Norton, population health market development manager for Western Europe, 3M Health Information Systems. “As a team, we are all very interested in the way Wellmark works in partnership with providers, incenting them to deliver better care for their members while not losing sight of the need to address public health with initiatives that help people live healthier lives.”

“We are all encouraged by the way Wellmark has focused on bending the curve of health care costs,” says Norton.