Health insurer Anthem Blue Cross and physician group HealthCare Partners have announced a new pilot program designed to replace traditional "fee-for-service" payments with a lump sum paid to physicians for the overall management of patient care, the Los Angeles Daily Journal reports.
Such partnerships, often called "accountable care organizations," aim to improve care coordination by providing physicians with more responsibility for patients and more control over services.
The pilot program will focus primarily on Anthem's Southern California members enrolled in PPO plans. In addition to HealthCare Partners, Orange County physician group Monarch HealthCare is expected to participate in the program.
The new pilot program marks a growing push toward risk-sharing partnerships among insurers, hospitals and other health care providers.
Earlier in 2010, Blue Shield of California launched a similar project with Hill Physicians Medical Group and the hospital chain Catholic Healthcare West.
Last week, the Hospital Association of Southern California proposed a plan to create a single foundation of multiple facilities to contract with physicians.
Maribeth Shannon, a policy director at the California HealthCare Foundation, said she expects such partnerships to become more common in the future. CHCF is the publisher of California Healthline.
Some health policy experts have warned that too much consolidation could threaten competition and eventually harm patients.
Advocates also have cautioned that the integration of health plans and physicians could provide a single entity with too much market control and could lead to disruptions in patient care (George, Los Angeles Daily Journal, 5/19).