Adirondacks ACO was selected as one of 123 new accountable care organizations (ACOs) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to coordinated care across the U.S., Health and Human Services (HHS) Secretary Kathleen Sebelius announced recently.
Adirondacks ACO is a seven‐county group comprised of an extensive network of providers to manage health care for Medicare beneficiaries. It includes more than 500 primary care providers in Clinton, Essex, Franklin, Hamilton, Warren, Washington and northern Saratoga counties in New York, as well Grand Isle and Chittenden in Vermont
Doctors, hospitals and health care providers establish ACOs in order to work together to provide higher‐quality coordinated care to their patients, while helping to slow health care cost growth, said Sebelius.
“Accountable care organizations are delivering higher‐quality care to Medicare beneficiaries and are using Medicare dollars more efficiently,” Sebelius said. “This is a great example of the Affordable Care Act rewarding hospitals and doctors that work together to help our beneficiaries get the best possible care.”
An evolution of the Adirondack Region Medical Home Pilot, which focuses on preventive care and enhanced management of chronic conditions, the Adirondacks ACO is focused on improving community health by delivering higher quality through greater coordination of care for our patients.
Participating primary care providers are from Fletcher Allen Partners (CVPH Medical Center, Elizabethtown Community Hospital, Fletcher Allen Medical Group), Adirondack Health/AMC, Alice Hyde Medical Center, Glens Falls Hospital, Irongate Family Practice, Hudson Headwaters Health Network and independent community primary care practices.
Stephens Mundy, president and CEO of CVPH Medical Center and chairman of the Adirondacks ACO said, his group is “a strong collaborative community organization of health care providers focused on improving health and quality through greater coordination of care for Medicare beneficiaries. I’m confident that the efforts of this extensive provider network will shape the future of both high quality health care delivery and payment reform in our communities.”
According to Mundy, ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using 33 quality measures on patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at‐risk populations.
Mundy said the new ACOs include a diverse cross‐section of health care providers across the country including providers delivering care in underserved areas. More than half are physician‐led organizations that serve fewer than 10,000 beneficiaries.
He said approximately one in five ACOs include community health centers, rural health clinics, and critical access hospitals that serve low‐income and rural communities. Affordable Care Act provisions have a substantial effect on reducing the growth rate of Medicare spending.
Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, and the trend continued into 2013, said Mundy. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades‐old pattern of spending growth outstripping economic growth.
The next application period for organizations interested in participating in the Shared Savings Program beginning January 2015 will be in summer 2014.
More information about the Shared Savings Program is available atwww.cms.gov/Medicare/Medicare‐Fee‐for‐Service‐Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram.