News in brief - Sept. 12, 2011

Mich. Blues' bid to become Medicaid MCO under review

A proposed partnership between Michigan's Blues plan and Philadelphia-based Independence Blue Cross will have to pass muster with Michigan's attorney general, whose office historically has been critical of the Blues and its planned acquisitions.

Blue Cross Blue Shield of Michigan announced its plan to buy a 40% stake in Medicaid managed care organization AmeriHealth Mercy Aug. 9. It is spending $135 million to buy the stake from Mercy Health System, a Catholic health system in Philadelphia. Independence Blue Cross, one of Pennsylvania's four Blues plans, holds the other 50% stake in AmeriHealth Mercy and will pay $35 million to boost its share to 60%.

Michigan Attorney General Bill Schuette said in a news release Aug. 18 that he would review the deal.

"We have a responsibility to ensure this substantial transaction conforms to state law and is in the best interest of Blue Cross rate payers and Michigan taxpayers," Schuette said in the release.

In March 2010, under former Attorney General Mike Cox, the office joined with the U.S. Dept. of Justice antitrust division to successfully block the Blues' attempted purchase of Lansing, Mich.-based Sparrow Health Plan.

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Study finds EMRs led to better outcomes for diabetic patients

A study published online Aug. 31 in The New England Journal of Medicine shows that diabetic patients treated in a practice with an electronic medical record system were significantly more likely to have better health outcomes, in a shorter period of time compared with those being treated in paper-based practices. The benefits were common across all insurance statuses, including uninsured.

The study involved 27,000 adults with diabetes living in the Cleveland area whose improvements were tracked over three years. The patients were being treated by 50 primary care physicians in 46 practices that were partners in a regional collaborative aimed at improving the value of care for patients with chronic disease (healthpolicyandreform.nejm.org/?p=15235&query=home).

While non-EMR patients also showed improvements, nearly 51% of EMR patients met all endorsed standards of care compared to only 7% of those in paper-based practices. EMR practices also had annual improvements in care that were 10% greater than paper-based practices and 4% greater annual improvements in outcomes.

Randall D. Cebul, MD, professor of medicine at Case Western Reserve University in Cleveland and lead author of the study, said the findings were significant because previous studies looking at EMRs have been conflicted with regard to how they impact quality of care and cost.

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First year of a private insurance ACO demonstrates good results

Numbers tracking outcomes from the first 12 months of a collaborative accountable care program set up by Cigna and the Medical Clinic of North Texas, a physician group with 43 locations in the Dallas-Fort Worth area, are positive, according to the insurer.

According to a statement issued Aug. 31 by Cigna, when compared with other patients covered by the insurer in the region, those cared for by Medical Clinic of North Texas in 2010 reduced avoidable emergency department visits by seven percentage points. Medical costs declined by two percentage points, and the hospital readmission rate declined by two percentage points.

Baseline numbers were not released, but the program is expected to continue at this and other locations where Cigna has launched similar initiatives.

As part of the Cigna's ACO project, the company shared patient-specific data with the clinic to identify those in need of additional outreach and follow-up care. The clinic expanded office hours to improve patient access, and hospitalized patients were able to visit the clinic within 72 hours of discharge.

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