- Associated Press - Thursday, August 7, 2014

DES MOINES, Iowa (AP) — Iowa’s leading health insurer said it has saved about $12 million by keeping patients well instead of treating them when they are sick.

The savings are less than 2 percent of the $734 million in overall care provided to about 358,000 patients over the past two years, The Des Moines Register reported (https://dmreg.co/1mpk87j ).

But Wellmark Blue Cross and Blue Shield said the savings from its Accountable Care Organizations are a start. It is an arrangement that rewards hospital and clinics for preventing expensive health care by treating patients before they become seriously ill.

Similar organizations have started around the country the past few years, partly because of incentives in the federal Affordable Care Act.

Mike Fay, Wellmark’s vice president of health networks, said the savings come from medical clinics encouraging patients to come in for checkups before their issues become severe. He said some clinic staff members have used electronic medical records to identify patients who often go to the emergency room for minor problems. He said staff members call patients to discuss cheaper ways to receive treatment.

Fay said health care providers have to meet certain goals to receive financial rewards, such as making sure children attend checkups and that adults get mammograms and colonoscopies when needed.

Wellmark said five health care systems that signed contracts for the Accountable Care Organizations all received monetary awards.

The health insurance company said hospital admissions reduced by nearly 12 percent and hospital re-admissions declined by 7 percent. It also said emergency room visits decreased by nearly 11 percent.


Information from: The Des Moines Register, https://www.desmoinesregister.com

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