QualCare spinoff looks to capitalize on ACO experience

September 17. 2012 1:34PM

The state's largest provider-sponsored health management organization, QualCare Inc., is using its experience forming accountable-care organizations to launch a spinoff business, Health-Lynx, under the parent company QualCare Alliance Networks Inc.

QualCare Alliance Networks CEO Annette Catino (left) and former vice president of business development Tim Ford said the provider-sponsored health organization's experience with health care reform has shaped its spinoff business, Health-Lynx.

Health-Lynx will be responsible for carrying on the work originally done by QualCare to bring together health care providers to create the integrated care groups established by the Affordable Care Act, said Annette Catino, CEO of QualCare Alliance Networks.

"We have been thinking about all of the implications of health care reform for three years now," Catino said. "We started trying to identify how we could find a role for us, as a provider-sponsored company, to help hospitals and doctors get engaged in the changes that were coming."

Initially, QualCare worked with several member hospitals to initiate coordinated care pilots for their own employees, and drew on that experience to help hospitals form networks for ACOs. So far, three of the ACOs QualCare helped draw up have been approved by the Centers for Medicare and Medicaid Services for participation in the shared-savings ACOs: Atlantic ACO, Barnabas North ACO and Hackensack Physician-Hospital Alliance ACO. Accountable-care organizations represent a new approach to health care delivery that seeks to coordinate medical care, engage patients in their own wellness, and improve health and control costs.

The company also is working on several other ACO applications, including ones for Barnabas Health's more southern hospitals, Meridian Health and Virtua. As more provider networks become interested in ACOs, Health-Lynx will be a vehicle to provide assistance in applying for ACO designation with the federal government, as well as expanding to other payers.

Health-Lynx will also use proprietary platforms to give providers access to patient population data that have been traditionally only used by payers for risk-adjustment.

Tim Ford, who previously served as QualCare's vice president of business development, will lead Health-Lynx as executive vice president.

Ford said Health-Lynx will focus its attention at hospitals first, because the way the company is established will help with the complex issues hospitals face with physician alignment and care coordination outside of the facility.

Catino said the investment to create Health-Lynx was originally made by hiring people with expertise in network development at QualCare. She estimated that Health-Lynx will be a self-sustaining company by 2014.