The Mount Sinai Health System has entered into an agreement with Empire BlueCross BlueShield that is designed to enhance quality of care and help individuals maintain healthy habits, all while reducing the cost of care. Empire is the largest health insurer in New York State.
Under the innovative agreement, which became effective January 1, 2015, Mount Sinai will manage all aspects of care for Empire’s 48,000 commercial and Medicare members who are attributed to the Health System. This includes coordinating all medical treatment, closely monitoring the patient between physician visits, and ensuring that appropriate follow-up care is received. Patients with chronic or complex conditions will receive individualized care plans tailored to their specific needs.
The agreement adopts an “accountable care” strategy that seeks to link provider reimbursements to overall quality of care and reductions in the total cost of care for a defined patient population. It is believed that such coordinated care will prevent costly duplicative services, and unnecessary emergency room visits and hospital admissions, and result in enhanced care overall.
“It is a good partnership when provider and payer are both focused on improving health outcomes, streamlining care models, and driving down costs,” says Kenneth L. Davis, MD, Chief Executive Officer and President, Mount Sinai Health System. “We are pleased to work with Empire BlueCross BlueShield to bring our expertise in primary care and population health management to bear in attaining these goals.”