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Shared Savings

(12). McCarthy D et. al. “The North Dakota Experience: Achieving High-Performance Health Care Through Rural Innovation and Cooperation” The Commonwealth Fund, May 2008. http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2008/May/The-North-Dakota-Experience--Achieving-High-Performance-Health-Care-Through-Rural-Innovation-and-Coo.aspx.[1]

• This case study incorporates elements of the supplemental payment and shared savings concepts. Blue Cross Blue Shield of North Dakota and an internal medicine clinic within MeritCare, an integrated delivery system, collaborated on a medical home pilot that provide MeritCare with a grant of $20,000 and the opportunity to share any savings 50%/50%. Total costs per member per year were $530 lower than expected in the intervention group based on historical trends, saving an estimated $102,000 for 192 patients in the pilot due to drops in hospital admissions and ER visits. Savings were even greater when comparing the intervention group to the control group. In addition, there was an 18% increase in the proportion of patients who received a bundle of five recommended services (compared to no significant change in the control site) and outcomes for patients in the intervention site were 5% to 15% better on four of five ambulatory care measures.

• Non-peer reviewed study

• Keywords: Shared savings; supplemental payments; Blue Cross Blue Shield of North Dakota; north Dakota; Blue Cross; MeritCare; medical home