Capital BlueCross/PinnacleHealth Accountable Care Arrangement

Program Location: 
Harrisburg, PA
Payer Type: 

In 2012, Capital BlueCross and PinnacleHealth System formed an innovative alliance designed to enhance care coordination, improve patient satisfaction and reduce health care expenses. This collaboration, known as an Accountable Care Arrangement (ACA), was one of the first of its kind between an integrated health care system and health insurer in Pennsylvania. 

Through this ACA model, Capital BlueCross works in conjunction with PinnacleHealth physicians to drive improvements in the health care delivery system. Capital BlueCross provides dedicated nursing resources, access to technology and critical analytics to PinnacleHealth’s physicians. This enables PinnacleHealth providers to deliver true patient-centered, integrated and holistic care. The two organizations use population-based clinical data to deliver highly-personalized medical care, resulting in increased doctor-patient face time, improved patient health and higher levels of patient satisfaction.

By working together, this arrangement between Capital BlueCross and PinnacleHealth aims to reduce redundancies and provide a more integrated approach to the delivery of medical services to more than 25,000 patients, designed to increase levels of customer satisfaction and reduce expenses. It follows as a natural extension of another ground-breaking partnership that the two organizations embarked on in 2010 when they successfully implemented one of the region’s first Patient-Centered Medical Home pilots.

In January of 2014, Capital BlueCross and PinnacleHealth System announced that they are teaming up to offer businesses a unique new health insurance plan for their employees. Marketed as CareConnect Point of Service (CareConnect), this plan connects the high-quality benefits and services of Capital BlueCross with the renowned physicians and facilities of PinnacleHealth. 

PinnacleHealth's partnership with Capital BlueCross is an extension of patient centered medical home for high risk and rising risk patients while its commitment to providing accountable care emphasizes the consistent achievement of high quality with costs that are below the region’s average.  Involving patients in his or her plan of care -- from disease prevention to managing chronic illness -- is integral in keeping health care costs low and providing coordinated care focused on the best outcomes.

CareConnect advantages include lower out-of-pocket costs, the freedom to visit any PinnacleHealth network provider without a referral, and an incentive program that provides rewards for health and wellness activities. Through the existing accountable care partnership between the two organizations, Capital BlueCross care guides and PinnacleHealth doctors collaborate to lead CareConnect customers to better health. Accountable care arrangements are patient-centered partnerships that focus on improving health care quality and outcomes, and reducing costs.

Last updated May 2014
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