UVMC takes on accountable care

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DAYTON — Premier Health ACO of Ohio has been selected to participate in the Centers for Medicare & Medicaid Services’s (CMS’s) innovative accountable care organization (ACO) model.

The goal of the model, known as the Next Generation ACO Model, is to improve health outcomes and lower costs for traditional Medicare patients.

Medicare ACOs are comprised of groups of doctors, hospitals, and other health care providers and suppliers who come together voluntarily to provide coordinated, quality care at lower costs to their traditional Medicare patients.

The ACO program began in 2012 with the Medicare Shared Savings Program and the Pioneer ACO Model. There are now more than 477 ACOs nationwide that serve approximately 8.9 million beneficiaries. Results from the past five years have shown that as ACOs gain more experience in these programs, they are able to provide better quality of care for beneficiaries while producing savings.

The Next Generation ACO Model is an initiative for ACOs that are experienced in coordinating care for populations of Medicare patients, including Premier Health ACO of Ohio. It will allow these provider groups to assume higher levels of financial risk and reward than are currently available under the current Pioneer ACO Model and Shared Savings Program. The goal of the model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for traditional Medicare fee-for-service (FFS) beneficiaries.

The Next Generation ACO Model advances the goal CMS announced in 2015 to move a growing percentage of Medicare payments into models that pay providers based on the quality rather than the quantity of care they provide to patients.

“We are excited to participate in the Next Generation ACO Model because of the opportunity it provides for our patients and our community,” said Jerry Clark, MD, chief executive officer for Premier Health ACO of Ohio. “It’s an important step to help Premier Health achieve the ‘Quadruple Aim.’ Many are familiar with the ‘Triple Aim’: improved quality of care, better patient experiences, while lowering total cost of care. We add a fourth component, which is improved engagement and provider satisfaction.”

The ACOs participating in the Next Generation ACO Model in 2017 have significant experience coordinating care for populations of patients through initiatives such as the Shared Savings Program and the Pioneer ACO Model. The Next Generation ACO Model organizations were selected through an open and competitive process from a large applicant pool.

For information, visit www.PremierHealthACO.org.

Staff report

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