BJC Accountable Care Organization

When your doctors can communicate more easily, you’ll receive better care that meets your unique needs. That’s our goal as the first Accountable Care Organization (ACO) in the St. Louis area. We work together with Medicare to provide high-quality service and care at the right time and in the right setting.

Patient benefits.

Discover how accountable care organizations help you coordinate between your various health care providers to increase effectiveness and efficiency of treatment.

Hear from Betty Hayward, a Medicare Beneficiary Representative.

If you do not have a primary care doctor, or want to switch to a doctor in an ACO, you can find one by registering with MyMedicare.gov and choosing a Primary Clinician.

Injuries or illnesses can happen quickly, and knowing where to get medical care is important. With BJC HealthCare, there are lots of options for medical care to fit your needs, from walk-in Convenient Care clinics to virtual visits online to emergency care. Know when and where to get the right medical care with this easy guide.

Virtual care, Convenient Care or Emergency Care: How to Choose the Right One

Doctor with patient
Meet our Care Partner team members

Our highly trained, experienced and compassionate team members guide and support you. 

More helpful resources.

These resources may help you make care decisions and prepare for conversations with your family, friends and doctors. These links are for different situations, and you likely will not need all of them. 

Note: all content and information on the websites are provided by outside organizations for informational purposes only. It is not intended to be relied upon as medical and/or legal advice and is not a substitute for legal advice and/or health care advice. BJC HealthCare and Washington University have no control over, or responsibility for, such content or any personal or financial information you provide to these websites. 

  • Step-by-step program with video stories to help you have a voice in your medical care.

  • Helping people share their wishes for health care.

  • Living with a serious illness? Advice to improve your qualify of life along with curative efforts.

  • Durable Power of Attorney for Healthcare forms and information from the Missouri State Bar.

  • Illinois State Bar information on health care decisions.

  • Form that can be printed and filled out with pertinent medical information and displayed in your home for first responders’ use if needed.

Read our patient stories. 

Medicare patients of BJC Medical Group doctors, after contact with their doctors, can choose to participate in the nurse care manager service as a part of BJC Accountable Care Organization.

Nurse care managers call patients when they are discharged from the hospital, or when they have been identified as being at a high risk of hospital admission due to chronic disease. Nurse care managers will also follow up with patients for several months if needed.

While they only talk by phone, an ACO patient knows she has a friend at the end of the line when she talks to Scotty Duranceau, BSN, RN. 

“We have absolutely formed a friendship,” says Connie, a BJC Accountable Care Organization (ACO) patient about her care partner.  “I just love Scotty to death. He is so professional yet personal. He makes me feel so much better.” 

Connie, who worked in health care in the past, has been dealing with multiple health issues and has been helped by Duranceau for about nine months. 

The feeling between the two is mutual. When asked about his patient, Duranceau replies enthusiastically. “She is great. We have absolutely formed a friendship and sometimes talk every other day. We discuss diet and exercise, and all kinds of things. She is limited on what she can do because of breathing issues, so I’m a support for her when she is having difficulties. She does what she needs to do but if it’s not working, I encourage her to ask for help.” 

The Care Management program is a part of BJC ACO. The program is delivered by a team of dedicated nurses, social workers and care coaches who provide outreach to patients by phone.  

Duranceau helps Connie with planning, understanding her health issues and he serves as the go-between with she and her doctor. Care partners work with providers to help individuals with chronic medical conditions overcome barriers to achieving improved health by promoting self-management with patients. 

“When I talk to him, I just feel better,” Connie says. “I’m sick, trying to do things to help myself, and Scotty helps. I am so happy to have this service that I tell everyone about it.” 

More on the Care Management program 

The Care Management Program is a voluntary service provided to Medicare patients of BJC ACO participants. Patients who don’t wish to participate in the program can opt out at any time. Eligible patients are identified by chronic conditions, risk levels using historical claims data and hospital discharge information. 

Providers may also refer patients into care management by contacting (314) 996-7020 or toll-free (844) 996-7020 or by submitting an ambulatory referral to ACO care management in Epic. 

Kathleen, 57, was a frequent user of Christian Hospital’s emergency room, always arriving by ambulance. She was a smoker with swallowing issues and breathing problems–and was unable to leave her home for very long. 

How Kathleen's nurse care manager helped: 

  • Working jointly with the Community Health Access Program (CHAP) at Christian Hospital that uses a paramedic to visit patients in their homes, the nurse care manager identified key issues for improvement 

  • Issues such as trash build-up, which was due to Kathleen’s inability to walk to the dumpster, and other medical and psychiatric issues were addressed to improve her quality of life 

Kathleen's patient testimony:  

  • Kathleen has gone from only eating ice cream to eating healthy meals and has decreased her smoking 

  • She has a cleaner home with better air quality and is now able to walk to the drug store to pick up her prescriptions 

  • Her calls to 911 have dropped from five times in a week to no calls over four weeks 

  • She is keeping her doctor appointments and has not been to the ER for three months 

Sandra had been a frequent user of emergency services for symptoms she believed were urinary infections. The nurse care manager contacted Sandra following one of these ER visits and developed a rapport.

How Sandra's nurse care manager helped: 

  • With comfort and trust, Sandra began calling her nurse with questions rather than just going to the ER

  • They found her symptoms were from a variety of causes, including medication side effects; Sandra is now seeing her primary care physician regularly and being treated for chronic back pain 

Sandra's patient testimony: 

  • She has also given up smoking and the medication side effects are better-controlled with a few changes 

  • She has not been back to the emergency department for a year 

When Dee was discharged from a rehabilitation facility after having her leg amputated, a nurse care manager reached out to her to help her adjust to the changes in her life. 

How Dee's nurse care manager helped: 

  • She was able to move Dee’s follow-up appointment with her primary care physician to three weeks sooner than originally scheduled 

  • She was able to arrange transportation so Dee could keep her appointment 

  • Within the week of her discharge, the nurse set up BJC Home Care Services to provide visits and rehabilitation in her home 

Dee's patient testimony: 

  • Dee was very happy with the help she received transitioning into new routines 

  • She was able to find a new place to live with improved accessibility 

Don, 36, had been hospitalized six times in under a year for congestive heart failure (CHF). After his last hospitalization in January 2014, a nurse care manager contacted him and followed him for the next five months. 

How Don's nurse care manager helped: 

  • She taught him about his disease, following a proper diet, and how to take his medication correctly 

  • When she discovered that he was not keeping his doctor appointments with his primary care physician because he did not feel comfortable with the doctor, she found a new one he was comfortable with 

  • She helped him quickly see the doctor, and he has continued to take his medication and keep all of his follow up appointments 

Don's patient testimony: 

  • He loves how he now feels 

  • He has not had any more issues or hospitalizations to date 

Printable Medication List.

This printable medication form provides you with an easy-to-fill-out medical record to keep with you in your wallet or purse. Use it to list your emergency contacts, immunization records, medical conditions, surgeries and all medications you are currently taking. 

View Form 

Pledge to your Health.

At BJC Medical Group, we care about your well-being and our providers are here to help you on your health journey. When you choose BJC, we ask you to Pledge to Your Health. Download this brochure and bring it to your next appointment for a discussion with your primary care provider. 

Pledge to Your Health

Recommended Exam and Vaccine Schedule.

As your primary health care provider, we are committed to helping you improve your overall health. We want to partner with you to better coordinate and manage your health care needs. 

We believe that focusing on your unique needs will help us provide the most effective and efficient health care possible. 

Annual visits help doctors catch health issues early and prevent many chronic health conditions. 

Below are some exams and vaccines that may benefit you, depending on your condition. Please check with your primary care physician to see which apply and when would be the appropriate timeframe to have them completed. 

Exams: 

  • Breast Cancer Screening – Mammogram (yearly) 

  • Colon Cancer Screening – Colonoscopy (every 10 years or as recommended by your physician) 

  • Depression Screening – PHQ (yearly) 

  • Diabetic Dilated Eye Exam (yearly) 

  • Diabetic Foot Exam (yearly) 

  • Fall Risk Assessment (yearly) 

  • Hepatitis C Screening (Once) 

  • Osteoporosis Screening-Bone Density Scan (every 10 years or as recommended by your physician) 

  • Physical/Regular Well Visit/Exam (yearly) 

Vaccines/Labs: 

  • Tetanus/DTap/Tdap Vaccine (every 10 years or as recommended by your physician) 

  • Hemoglobin A1C (6 months) 

  • Flu/Influenza Vaccine (yearly) 

  • Cholesterol/Lipid Panel (yearly) 

  • Pneumonia/Pneumococcal 65+ (once or as recommended by your physician) 

  • Urine Microalbumin (yearly) 

  • Shingles/Zoster Vaccine (Once) 

 

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