Emory Healthcare, Walmart Team Up for an ACO, Bundled Payments

April 23, 2018 - Atlanta-based Emory Healthcare recently announced the creation of an accountable care organization (ACO) with retail giant Walmart, known as the Accountable Care Plan.

Walmart employees at 55 Walmart, Sam’s Club, and Walmart Distribution Center locations in the metro-Atlanta region have been able to enroll in the Accountable Care Plan since Jan. 1, 2018. The employees in the ACO program have access to healthcare services at Emory Healthcare’s seven hospitals and 200 provider locations.

Emory Healthcare is one of the largest clinically integrated networks in Georgia with 2,000 physicians in over 70 specialties, including 240 primary care physicians. The health system draws in over $2 billion in net patient revenue and already participates in three other ACOs, according to data from Definitive Healthcare.

Under the new ACO program with Walmart, employees who enroll in the Accountable Care Plan as their primary healthcare plan will not have to pay for preventative visits. Although they will face standard co-pays for primary care, specialist, and urgent care visits.

The new partnership is another example of how retailers are disrupting the healthcare market.

Untraditional partners like Amazon and Walmart are venturing into the healthcare space on their own to transform how care is paid for and delivered. For example, Amazon, Berkshire, and JP Morgan unveiled the formation of an independent healthcare company for their employees earlier this year.

Walmart is similarly aiming to disrupt the healthcare market. The retail behemoth is reportedly engaging in talks to acquire Humana and an online pharmacy start-up called PillPack, CNBC recently reported.

Emory Healthcare views their partnership with Walmart as a step in the right direction for high-quality, affordable care.

“When Walmart approached Emory about these opportunities, we were excited to partner with Walmart, a progressive company dedicated to transforming healthcare and its delivery process,” said Patrick Hammond, Emory Healthcare Network CEO. “More and more large, self-insured employers like Walmart are looking for new and creative solutions as a potential way to decrease costs of healthcare plans for employees, while improving the overall quality of the care. This partnership is a win-win for everyone involved.”

Walmart’s Senior Director of Healthcare Benefits for US locations Lisa Wood added that Emory Healthcare was an ideal partner because of its experience with alternative payment models and high-value care.

“We continue looking for innovative ways to support our associates and ensure they receive the best and most appropriate care,” she said. “Not only does Emory offer a quality provider network, but Emory has also been a great partner in supporting payment reform initiatives. We appreciate Emory’s willingness to innovate with us as we evolve our programs.”

In addition to the ACO program, Emory Healthcare also unveiled that Emory University Orthopaedics & Spine Hospital (EUOSH) and Emory Orthopaedics & Spine Center have been involved in Walmart’s Centers for Excellence bundled payments program as of Jan. 1, 2018.

The Centers for Excellence program is a national bundled payments model for spine and joint replacement surgeries. Some facilities currently participating in the program include Mercy Hospital Springfield in Missouri, Virginia Mason Medical Center in Washington, Geisinger Medical Center in Pennsylvania, and Mayo Clinic facilities in Arizona, Minnesota, and Florida.

Walmart employees undergoing spine and joint replacement surgeries in the metro-Atlanta area can now go to two of Emory Healthcare’s facilities. Under the Centers of Excellence program, Walmart employees in sponsored health plans, like the Accountable Health Plan, will not pay out-of-pocket costs for certain spine and joint replacement surgeries at the two participating Emory Healthcare facilities. Walmart will also cover travel-related costs.

Accountable Care Plan members will also have access to certain weight loss and cardiac surgeries under the Centers of Excellence program, the announcement added.

“We are excited that Walmart has chosen EUOSH and the Emory Orthopaedics & Spine Center as part of its Centers of Excellence program,” explained Scott Boden, MD, Emory Orthopaedics & Spine Center Director and Chairman of Emory Healthcare Network’s Board of Directors. “Walmart’s decision recognizes that having a group of physicians, nurses and staff dedicated solely to joint replacement and spine surgery translates directly into better outcomes for their employees and families. When you have people and a facility that focus on performing just one or two areas of surgery, it allows you to achieve efficiencies and results that are difficult to achieve in a conventional hospital setting.”