Seton Healthcare Family hospitals and the physician multispecialty group Aus- tin Regional Clinic. More recently, the alliance branched out to include other community physicians and partners such as Lone Star Circle of Care, a fed- erally qualified health center with what Gregory S. Sheff, MD, described as ad- vanced medical home capabilities. He is president and chief medical officer of the Seton Health Alliance and executive vice president of clinical systems for the Seton Healthcare Family. “Our goal is to transform our delivery system to deliver value. And we want to use this [commercial ACO contract] as a vehicle to grow our physician network focused on value-based care,” Dr. Sheff said. To achieve that transformation, for
example, physicians in the Seton-United ACO use an electronic medical records system to get monthly updates on their patients’ status and track and coordinate
tests, screenings, medications, and all of the care that patient is receiving. Physicians are eligible for financial incentive payments based on quality improvements in measures such as re- admission rates, disease management and prevention, patient safety, and care delivery. For now, the program uses a shared savings model in which the hos- pitals and physicians share any savings generated through such initiatives, but leaves the door open for other value- based payment models.
The Seton Health Alliance began as
a Pioneer Medicare ACO in 2011, which served as a launchpad for the commer- cial venture by helping it create the needed infrastructure, Dr. Sheff says. “Because commercial contracts can be locally negotiated, they can be more aligned with the realities of the Central Texas market. We’re using this contract as our opportunity to reach out to and integrate with community physicians.”
He acknowledges that for small phy- sician practices, mustering up the infra- structure on their own to deliver inte- grated care is not feasible. An ACO, on the other hand, presents an opportunity for individual practices to organize and transform without having to sell their practices or become employed. United executive David Milich said
the ACO approach “can help improve care for our 320,000 health plan custom- ers in Central Texas and make the health care system work better for everyone.” The trend doesn’t stop in Central Tex- as. United says more than $20 billion of its annual physician and hospital reim- bursements are tied to accountable care programs and other performance-based programs. n
Amy Lynn Sorrel is an associate editor of Texas Medicine. You can reach her by telephone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
42 TEXAS MEDICINE October 2013
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