Partners HealthCare, one of just 23 Pioneer Accountable Care Organizations (ACO) in the nation, has successfully lowered health care cost growth for the second year in a row among approximately 60,000 Medicare patients, according to new federal data. The Pioneer ACO initiative, sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, aims to transform the way that health care is delivered by providing Medicare patients with higher quality, while slowing cost growth through enhanced care coordination.
During year two of the initiative, Partners HealthCare was successful in slowing the rate of cost growth by 0.46% as compared with the benchmark that Medicare used to measure Partners’ performance. This translates into approximately $3.3 million in savings.
When combined with the year one results, Partners efforts have achieved $17.7 million in savings. Under the Pioneer ACO model, some of these savings have been shared between the federal government and Partners.
Even more importantly, the data shows that Partners delivered high quality care to Medicare patients at the same time that these savings were achieved. Partners rates well in virtually every quality indicator that the federal government tracks and Partners achieved among the lowest mortality rates as part of the initiative. Partners was rated at or above the 90th percentile of performance on 23 of 33 measures tracked in the Pioneer ACO initiative.
“We are constantly focused on delivering the highest quality care and best value possible to our patients and their families,” said Gary L. Gottlieb, MD, President and CEO of Partners HealthCare. “These results in the Pioneer ACO show that it is possible to slow cost growth, while improving care. The valuable lessons learned will help enhance the way we deliver care to all of our patients.”
“The most important story here is that the quality of patient care in Massachusetts is exceptional, and getting better,” said Gregg Meyer, MD, Chief Clinical Officer at Partners HealthCare. “Through this initiative, Partners Healthcare and four other Massachusetts health care providers – Atrius Health, Beth Israel Deaconess, Mount Auburn, and Steward – are literally pioneers, leading the way, developing a blueprint for the nation to follow when it comes to improving quality and slowing cost growth.”
The Pioneer model is designed to encourage the development of accountable care organizations, which are groups of doctors and other health care providers who work together to provide high quality care for their patients. Partners was chosen specifically as one in a diverse group of leading-edge health care organizations from around the country to test the effectiveness of several new models of payment.
Partners achieved these results through a sharp focus on, and investment in, population health management (PHM). PHM is an approach to medicine that invests in services that improve patient access to care, helps patients navigate the complex health care system, and provides more information to patients – helping them make the best possible health care decisions.
To achieve this, Partners is currently in the midst of transforming all of its primary care practices into ‘Patient-Centered Medical Homes.’ Patient-Centered Medical Homes are primary care offices in which doctors and other caregivers 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). This is a Partners program in which nurse care managers are assigned to oversee complicated and chronically ill patients with many 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 the overall costs for them by preventing avoidable hospital visits.
Find more information on Partners' efforts.
About the Pioneer ACO
Under the Pioneer ACO Model, CMS provide incentives for participating health care providers who form an organization to coordinate care for patients. Providers who band together through this model are required to meet quality standards based upon, among other measures, patient outcomes and care coordination among the provider team.
CMS uses robust quality measures and other criteria to reward ACOs for providing beneficiaries with a positive patient experience and better health outcomes, while also rewarding ACOs for reducing growth in Medicare expenditures for the same patient population.
Unlike a managed care plan, Medicare beneficiaries are not locked into a restricted panel of providers. The Pioneer ACO Model is not a health plan or managed care plan. Under the Pioneer ACO Model, beneficiaries seeing doctors participating in an ACO will maintain the ability to see any doctor or healthcare provider, as well as the full benefits associated with traditional Medicare.
A History of Partnership
Partners has a history of partnering with CMS to improve care and reduce costs. In 2006, Massachusetts General Hospital (MGH) launched the Care Management Program, one of six demonstration projects nationwide. During the three-year demonstration, MGH developed new strategies to improve the delivery of health care to its most vulnerable high risk patients, those with multiple health conditions and chronic disease. The demonstration was so successful that in 2009 CMS renewed it; the initiative was expanded to Brigham and Women’s and North Shore Medical Center. Learn more about the Care Management Program.