Friday, August 30, 2013

Pioneer ACO participation shows promise after first year

The Centers for Medicare and Medicaid Services (CMS) has announced results from the first year of its Pioneer Accountable Care Organization (ACO) model, which seeks to improve care while reducing costs for Medicare patients.

“Partners HealthCare is one of 32 hospital systems and physician groups across the U.S. that participated in the ACO experiment, and the results were both positive and promising,” says Timothy Ferris, MD, MPH, medical director of the MGPO and vice president for Population Health Management at Partners, who leads the Partners ACO effort. “Partners was able to reduce the rate of cost growth by 2.4 percent compared to a national benchmark, which translates into $14.4 million in savings for the 52,000 Medicare patients cared for in the Partners ACO in 2012. The savings will be shared equally by Partners and CMS.”

These significant savings were achieved while also delivering high-quality care to Medicare patients. Partners exceeded national averages in nearly all quality indicators tracked by CMS and maintained an extremely low mortality rate.

“As health care evolves in this country, we have an obligation to ensure that we deliver the best value possible to our patients and their families,” says Gary L. Gottlieb, MD, MBA, president and CEO of Partners. “These results show that it is possible to slow cost growth while delivering high-quality care. We are confident that this Pioneer ACO initiative can provide a blueprint for the rest of the nation to follow.”

Partners achieved these results through a sharp focus on and investment in population health management, an innovative approach to medicine that helps patients navigate the complex health care system. To achieve this, Partners is currently in the midst of transforming all of its primary care practices into “Patient-Centered Medical Homes,” which are primary care offices where clinicians work as teams to coordinate care for patients, improving both clinical outcomes and patient satisfaction. 

Additionally, Partners is focused on medically complex patients through its integrated care management program (iCMP). In this Partners program nurse care managers oversee complicated and chronically ill patients with multiple medical conditions, such as diabetes or heart disease. By monitoring patients’ health closely and ensuring they comply with their doctors’ instructions, iCMP helps keep these high-risk individuals healthier and lowers overall costs by preventing avoidable hospital visits.

Four of the five Boston-area ACOs achieved cost savings, but only 18 of the 32 ACOs across the country did. “We know that systemic changes to transform health care delivery and ensure long-term success will take some time,” says Ferris. “Partners has made a serious investment and commitment to achieving value in health care. As encouraging as our first-year results are, it is important to remember that we have much hard work ahead of us to maintain this level of success.”

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