Capital BlueCross, Heritage Medical Group Embark on Landmark Agreement to Launch an Accountable Care Arrangement

HARRISBURG, Pa., April 27, 2011 /PRNewswire/ -- Capital BlueCross announced today an expanded partnership with Heritage Medical Group that will enhance coordination of patient care, dramatically improve quality, slow cost growth and significantly improve health outcomes.

By working together, this new agreement will provide a more comprehensive, accountable approach to the delivery of medical services.  It follows as a natural extension of other recent innovative provider arrangements by Capital BlueCross, including the successful implementations of Patient-Centered Medical Home pilots in 2010.

The program, set to begin May 1, 2011, brings expanded medical value to the members of our community and represents a groundbreaking way in which health care will be delivered.  

"Our current system of care is fragmented and interests are not always aligned. Under this new partnership we have the opportunity to create a much more patient-centric, data driven health care system that will result in better access to care, service to patients and the use of clinical evidence aimed at delivering care more effectively," said Dr. Christopher Rumpf, Capital BlueCross Chief Medical Officer.

During the multi-year partnership, Heritage Medical Group primary care practices and Capital BlueCross will share claims and medical record data on a real time basis in order to identify Capital BlueCross members who can benefit from stronger outreach efforts designed to monitor and coordinate the patient's total spectrum of medical care. By focusing on the needs of the patient, particularly those with chronic conditions, and working with the patient to establish and manage a comprehensive plan of care, the parties believe they can increase doctor-patient face time, improve patient health and satisfaction, establish and monitor continued treatment, and help to reduce waste and care fragmentation.

As an example, Doctor Rumpf pointed out that a Capital BlueCross member diagnosed with type II diabetes will now receive an enhanced level of care coordination from Heritage for all preventive care, ongoing treatment and specialty care, no matter which Heritage physician or specialist the member has accessed.

"Our member in this illustration would be assigned a Capital BlueCross Care Coordinator who will work closely with Heritage caregivers to ensure that patient has timely doctor appointments, on-site blood glucose tests, a customized nutrition and exercise program, a support group, and a comprehensive understanding of the medical bills and insurance benefits," he said. "Ultimately this will help the member to live a more healthful life. This elegantly simple approach will make all the difference to our members."

The agreement also includes new payment methods for Heritage Medical Group and provides incentives for meeting key benchmarks focused on high-quality coordinated medical care, customer service and health outcomes.

"This promising pilot agreement is an example of what well-intended health care partners can do to provide true medical value for our shared patients and members," said Dr. David Froehlich, Associate Medical Director, Heritage Medical Group. "We believe this partnership, focused on improving quality that will lower costs in the long-term, can be a model of care for others to follow."

"With the exceptional reputation Heritage has as a service-oriented, high-quality professional practice, Capital BlueCross has surely aligned itself with the right physician group to launch an accountable care approach to primary care," said Doctor Rumpf.  "Now patients -- our members -- can look forward to an approach to care that takes them through the whole process, one that often begins before they even enter the office and continues long after they exit. Capital BlueCross is the leader in delivering medical value to the communities we serve, and this landmark agreement is an exciting and powerful next step."

About Capital BlueCross

Capital BlueCross is the leading health insurer in its region, providing health insurance coverage to residents in central Pennsylvania and the Lehigh Valley.

Capital BlueCross is committed to making health insurance simple for its customers and members through all the stages of life by offering nationally acclaimed customer service and a full range of innovative benefit programs for groups and individuals at competitive prices.

By establishing a culture of caring, Capital BlueCross constantly strives to do more in order to deliver more for the men, women and children who depend on the company for their health insurance needs. Capital BlueCross has been providing medical value to the people and communities of central Pennsylvania and the Lehigh Valley for more than 70 years and employs about 2,000 people in the region.

Headquartered in Harrisburg, Pa., Capital BlueCross is an independent licensee of the Blue Cross and Blue Shield Association.

More information about Capital BlueCross and its subsidiaries can be found by going to www.capbluecross.com.

About Heritage Medical Group

Heritage Medical Group represents some of the finest and most respected independent practitioners in the Harrisburg, Pa area. Member practices represent both primary care providers and specialists, and encompass a geographically diverse area.

Heritage Medical Group is a multi-specialty physician group created in March of 1998 through the merger of 10 independent physician practices comprised of over 40 physicians in the area.

Today, Heritage Medical Group has 17 different offices and over 80 providers. Currently, the company is located in Cumberland and Dauphin counties, and continues to grow.

More information about Heritage Medical Group can be found by going to www.heritagemedgrp.com.

SOURCE Capital BlueCross