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HomeMy WebLinkAbout~Master - Accountable Care Organization 2016 Pilot Program with Wellmark RESOLUTION NO. 15-644 RESOLUTION APPROVING 2016 ACCOUNTABLE CARE ORGANIZATION PILOT PROGRAM WITH WELLMARK FOR THE CITY OF AMES WHEREAS, for the 2015 calendar year,the City has been participating in an Accountable Care Organization (ACO) pilot with Wellmark, and this is a program for those receiving health insurance benefits through the City of Ames as employees, retirees, spouses or dependents; and, WHEREAS, an Accountable Care Organization is a local health care provider that is held accountable for the quality and cost of the care it delivers; and, WHEREAS, Wellmark already uses an ACO model for everyone covered by Wellmark insurance, and last year, Wellmark took a next step by inviting 10 employers whose health care benefits are self-funded,and for whom Wellmark provides administrative services,to participate in a 2015 ACO pilot; and, WHEREAS,the first year was a"no cost"initiative approved by City staff that gave the City an opportunity to explore the ACO model and concept, and Staff is now proposing that the City continue as a participant for the next phase of Wellmark's ACO pilot in 2016; and, WHEREAS, an ACO is not an insurance product or benefit; rather, it is an agreement between providers and payers to incentivize value-based healthcare; and, WHEREAS, healthcare providers are held accountable and share in both the risk and the benefits; incentives are paid to providers when quality targets are met or improve above the target; and, WHEREAS, each ACO must also meet Wellmark trend and Consumer Price Index cost targets in order to receive incentives, and if an ACO does not meet its targets,it pays back losses to the company or employer that pays the claims; and, WHEREAS, while the City of Ames continues to evaluate the ACO Model, over time we hope to gain multiple benefits; and, WHEREAS,these include improvement in quality of care,reductions in the rate of increase in health care costs,population level reports split by clinical risk groups, and outreach to specific patients in the form of greater disease management and care navigation by the ACOs. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Ames, Iowa, that authorization of an agreement confirming the City of Ames' participation in Wellmark's 2016 ACO pilot program, contingent upon a maximum shared savings cost to the City of$25,000 and receipt of specific employee healthcare data by risk group, is hereby approved. ADOPTED THIS 13`h day of October, 2015. A. tom• ��� Diane R. Voss, City Clerk Ann H. Campbell, Mayor Introduced by: Betcher Seconded by: Corrieri Voting aye: Betcher, Corrieri, Gartin, Goodman,Nelson, Orazem Voting nay: None Absent: None Resolution declared adopted and signed by the Mayor this 131h day of October, 2015.