Partners HealthCare, one of the original Pioneer Accountable Care Organizations (ACO), has successfully improved the quality of care provided to approximately 84,000 Medicare patients, according to new federal data released today. The Pioneer ACO initiative, sponsored by the Center for Medicare & Medicaid Innovation (CMS Innovation Center), aims to transform the way that health care is delivered by providing Medicare patients with higher quality care, while slowing cost growth through enhanced care coordination.

Over the past four years, Partners’ efforts have reduced costs of care for Medicare by $31.5 million (of which Partners has received $20.4 million). In the fourth year of participation, Partners did not generate savings, narrowly missing cost containment goals by 0.8%.  However, the federal government did highlight several notable improvements in specific categories. Partners’ growth in expenses for patients with disabilities and patients with end stage renal disease was lower than their ACO benchmark (a reduction of 1.6 and 1.3 percentage points respectively). Partners attributed the reduction in expenses to the high risk care management program, which assigns nurse care managers to care for chronically ill patients with multiple medical conditions, and is helping to lower costs and improve care.  Currently, Partners is managing the care of over 10,000 high risk Medicare patients.

Over the past four years, Partners’ efforts have reduced costs of care for Medicare by $31.5 million.

Partners also trended better than the benchmark in non-inpatient care and skilled nursing facility expenditures.  The growth in nursing facility expenditures was 1.1 percentage points lower than the growth in the national Medicare population, which suggests Partners’ programs are making a difference in reducing costs and providing more efficient care.  Hospice use among the Partners network has increased, indicating more of our patients are benefitting from this important service.

As in previous years, Partners continues to deliver high quality care to Medicare patients. Partners scores well in virtually all quality indicators that the federal government tracks as part of the Pioneer ACO initiative. With an overall quality score of 96.04%, Partners is among the best ACOs in the nation for delivering high-quality care to patients. Partners scored exceptionally in two of the four measurement domains receiving a 100% quality score in preventative health screening and managing at-risk populations.

“These year-four results contain some continued encouragement,” said Tim Ferris, MD, Senior Vice President for Population Health Management at Partners HealthCare.  “We are also reminded of the numerous challenges and will refocus our efforts to ensure that we achieve our goals of both improving quality and reducing the growth of healthcare costs.”

With an overall quality score of 96.04%, Partners is among the best ACOs in the nation for delivering high-quality care to patients.

The Pioneer ACO 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 improves patient access to care and helps patients navigate the complex health care system. PHM provides more information to patients - helping them make the best possible health care decisions. 

For more information on Partners efforts, click here.

About the Pioneer ACO

Under the Pioneer ACO Model, CMS provides 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.  To learn more about the Care Management Program click here.