For the last few years, Dallas Area Rapid Transit has watched its employee-healthcare costs rise by 7 percent to 10 percent annually. So the 3,600-employee agency, which is self-insured for health insurance, decided to make a big change.
Beginning January 1, DART will offer its employees and their dependents an innovative ACO health plan created by the Dallas-based Baylor Scott & White Quality Alliance, Arkansas-based HealthSCOPE Benefits, and benefits consultant Willis Towers Watson.
The new plan is said to be one of the first of its kind in North Texas, in that an employer is contracting directly with a TPA (HealthSCOPE) and an accountable care organization to deliver value-based care. The plan’s aim: generating positive health outcomes and reduced costs for DART and its employees.
DART’s offering will use BSWQA’s ACO, which includes 5,000 primary and specialty care physicians, 48 hospitals, and a number of post-acute care facilities. Among other things, BSWQA says it’s committed to closing the gaps in care for DART employees, helping those with chronic illnesses better manage their conditions, and increasing the number of preventive health visits.
Dr. Cliff Fullerton, president of BSWQA, says his clinically integrated network has already proven its value with the group’s own employee population, slashing hospital admissions by 13 percent and saving $57 million for employees over four years.
It’s also taking on some financial risk with the DART plan, Fullerton adds. Confirms Jesse Oliver, DART’s deputy executive director: “It’s a shared situation. If we don’t see some improvements in the employees’ healthcare … there are provisions in the contract that [BSWQA would] rebate some money back.”
Oliver says DART will offer a “traditional PPO” plan in addition to the BSWQA arrangement in order to give employees more choice.
BSWQA began talking with DART about the new plan three years ago, Fullerton says, adding that the contract is for four years, with two two-year extensions.