Montefiore Medical Center and Empire BlueCross BlueShield have formed an Accountable Care Organization, or ACO, that will offer advanced care management services to Empire’s fully insured members in Westchester County and the Bronx and to employees in Montefiore’s self-funded plan administered by Empire.
It is Empire’s first ACO agreement in the New York region. The ACOs are part of the health care reform measures included in the Affordable Care Act and are designed to improve care for patients and lower health care costs while paying and rewarding hospitals, physicians and other providers for quality and outcome of care.
Empire members already seeing primary care and specialty physicians affiliated with Montefiore will be eligible for care coordination services to help manage chronic illnesses prevalent in this region, such as diabetes, coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease and asthma. All members also will have access to wellness and preventative care and will receive educational support in managing their own health. Montefiore employs more than 200 specially trained care managers who will work with ACO participants.
Montefiore and Empire officials in their joint announcement said the goal of the new agreement is to help insurance plan members stay as healthy as possible by getting the right care in the right place and at the right time, avoiding unnecessary emergency room visits and hospital admissions. As part of the ACO’s pay-for-performance model, Montefiore will be eligible for additional compensation if quality standards are met.
Montefiore Medical Center, the university hospital of the Albert Einstein College of Medicine in the Bronx, has corporate offices in the South Westchester Executive Park in Yonkers. The hospital recently announced its pending deal to acquire a 300,000-square-foot office complex in Tarrytown from Kraft Foods Inc., where it plans to relocate its business and administrative offices from Yonkers. The hospital plans to expand its information technology operations at its Yonkers offices.
Montefiore Medical Group operates ambulatory care centers in Yonkers, Larchmont, Eastchester and Scarsdale.
