Federal health officials selected 32 health care systems, including several led by physician groups, to take part in the new Medicare pioneer accountable care organization initiative.
The Dept. of Health and Human Services estimates that $1.1 billion in savings could be realized from the ACO model, which encourages physicians and hospitals to coordinate care and offers shared savings for keeping patients healthy. Pioneer ACOs also face penalties when health care costs exceed projections. The pioneer ACO model was designed for health care groups with experience in providing patient-centered care.
The pioneer program, which begins on Jan. 1, 2012, is separate from the system-wide ACO shared savings program that was finalized in October. "We know that health care providers are at different stages in their work to improve care and reduce costs," said Marilyn Tavenner, acting Centers for Medicare & Medicaid Services administrator. "That's why we've developed a menu of options for Medicare to meet doctors, hospitals and other health care providers where they are, and begin the conversation of how to enhance the care they are offering to people with Medicare."
More than 100 entities had showed interest in the program, said Richard Gilfillan, MD, director of the CMS Center for Medicare and Medicaid Innovation. About 80 groups submitted formal applications, and only 32 were selected after a rigorous review process.
The American Medical Association was pleased to see more than 30 systems, including several physician-led groups, selected for the initiative, said AMA President Peter W. Carmel, MD. "The pioneer program provides an important opportunity for physicians who are ready to participate in an ACO now, while other groups can begin the process of forming a Medicare ACO in CMS' program throughout 2012."
The innovation center selected Physician Health Partners, which includes more than 260 primary care physicians based in Denver, as one of the pioneers. The organization cares for 450,000 patients in a seven-county area.
"We are excited to showcase our unique model that has been shown to improve health outcomes," said Kenneth Nielsen, president and CEO of Physician Health Partners. "This is an opportunity for us to demonstrate the importance of primary care physicians and the role they will play in future reform efforts."
Monarch HealthCare in Irvine, Calif., also was selected. The independent practice association consists of 2,300 independent physicians who care for 176,000 patients.
"This is very good news not only for Monarch HealthCare, but for Medicare beneficiaries in California," said Bart Asner, MD, the group's CEO. "We are confident that our innovative approach to enabling greater coordination among physicians will allow us to further enhance the exceptional care our patients receive from their Monarch physicians today."
Pioneer ACOs will practice in 18 states. The other groups selected are: Allina Hospitals & Clinics, Atrius Health, Banner Health Network, Bellin-Thedacare Healthcare Partners, Beth Israel Deaconess Physician Organization, Bronx Accountable Healthcare Network (BAHN), Brown & Toland Physicians, Dartmouth-Hitchcock ACO, Eastern Maine Healthcare System, Fairview Health Systems, Franciscan Alliance, Genesys PHO, Healthcare Partners Medical Group, Healthcare Partners of Nevada, Heritage California ACO, JSA Medical Group, Michigan Pioneer ACO, Mount Auburn Cambridge Independent Practice Association (MACIPA), North Texas ACO, OSF Healthcare System, Park Nicollet Health Services, Partners Healthcare, Presbyterian Healthcare Services-Central New Mexico Pioneer ACO, Primecare Medical Network, Renaissance Medical Management Company, Seton Health Alliance, Sharp Healthcare System, Steward Health Care System, TriHealth Inc. and University of Michigan.
The full and original article can be found at: http://www.ama-assn.org/amednews/2011/12/26/gvsf1229.htm