Accountable Care Organization Takes Root in San Francisco

Pilot Builds on Success in Sacramento; Includes One of Nation's Top Health Systems, and One of Nation's Top 10 Medical Centers

San Francisco, CA - March 2, 2011 - A new Accountable Care Organization (ACO) took root in San Francisco this week with the approval of an employee benefits agreement between the City and County of San Francisco (CCSF) and Blue Shield of California. The ACO program, led by St. Mary's Medical Center and Saint Francis Memorial Hospital of Catholic Healthcare West (CHW), UCSF Medical Center, and Hill Physicians Medical Group will be available to active employees, retirees and dependents of the city and county who choose the Blue Shield HMO plan during the April open enrollment period.

"We've shown through our partnership with Hill Physicians in the Sacramento area that a coordinated care model involving top physicians and hospitals, working closely to achieve clinical integration, can result in a comprehensive, patient-centered care experience," said Bill Hunt, executive vice president/chief operating officer for CHW. "We're pleased that St. Mary's Medical Center and Saint Francis Memorial Hospital are joining Hill Physicians and UCSF in bringing this enhanced care experience to San Francisco."

"This builds on success, while also being uniquely San Franciscan," said Steve McDermott, CEO of Hill Physicians. "We've shown that independent physicians and community hospitals can coordinate high-quality care around an individual's health, creating a smoother experience for the member before, during and after a hospital stay. Now, we're taking that ACO coordination to the next level by extending our CHW partnership through its San Francisco hospitals and including the nationally recognized strengths of UCSF Medical Center."

In 2009, CHW, Hill Physicians and Blue Shield launched an ACO pilot in Sacramento to serve more than 40,000 California Public Employees' Retirement System (CalPERS) members. Results from the first year of the pilot showed impressive increases in clinical measurements and cost management, and generated anecdotal feedback from members who felt more actively engaged with their doctor and their own health. The collaboration has succeeded in preventing premium increases, and has achieved an estimated 22 percent reduction in hospital re-admissions and $20 million in savings.

The program in San Francisco is expected to benefit from the lessons of the Sacramento pilot, but also will be tailored to meet the needs of the CCSF population. The collaboration among Hill, CHW and UCSF creates a similar "virtual integrated model" of care, in which all three organizations are aligned to improve quality, cost and service to employees of CCSF. This ACO is one of the few in the nation - and the only one in northern California - that includes an academic medical center.

"Collaborating with our community partners on a new care model aligns well with UCSF's goals of finding new ways to improve the quality and cost-effectiveness of care, while increasing patient satisfaction," said Jay Harris, chief strategic planning officer for UCSF Medical Center. "This approach is a perfect example of the innovative approaches that cities and health plans must take to make health care more affordable without compromising quality."

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