Partners HealthCare, one of just 19 Pioneer Accountable Care Organizations (ACO) in the nation, has successfully lowered health care cost growth among approximately 70,000 Medicare patients, according to new federal data released today. The Pioneer ACO initiative, sponsored by the Centers for Medicare & Medicaid Services Innovation Center (CMMI), 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.

“Each year we learn more about the best approaches to caring for our Medicare patients, and one of the big lessons learned is that partnering with the federal government on innovative payment models can make significant improvements in the health care system,” said David Torchiana, MD, President and CEO of Partners HealthCare.  “Our work, combined with the work of other Boston-area pioneers including Atrius, Beth Israel Deaconess, Mount Auburn and Steward, is helping to craft a blueprint for the rest of the nation as we all work toward improving patient care and controlling costs.” 

During the third year of the initiative, Partners HealthCare was successful in reducing spending by 2.7% as compared with the benchmark that Medicare used to measure Partners’ performance.  This translates into approximately $21.6 million in savings during year three. 

When combined with results from years one and two, Partners’ efforts have achieved $39.2 million in savings.  Under the Pioneer ACO model, some of these savings have been shared between the federal government and Partners. Of this three-year total, Partners shared in $20.4 million of the savings and the federal government shared the other $18.8 million.

Even more importantly, the data shows that Partners continued to deliver high quality care to Medicare patients at the same time that these savings were achieved.  Partners rates well in virtually all quality indicators that the federal government tracks as part of the Pioneer ACO initiative.  With an overall quality score of 88.85%, Partners is among the best ACOs in the nation for delivering high-quality care to patients. Partners compared favorably with the rest of the nation in 27 of the 33 performance measures tracked.  In the area of behavioral health, Partners succeeded in nearly doubling the rate of depression screening among Medicare patients through heightened education efforts, improved clinical protocols and tools embedded in the electronic health record.

“These year three results prove that this is a model that can work,” said Tim Ferris, MD, Senior Vice President for Population Health Management at Partners HealthCare.  “We’re seeing improvements in most aspects of our seniors’ care, particularly in the area of mental health. Models like the Pioneer ACO enable better integration of behavioral health services and primary care, and it is paying dividends for our patients.”

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.

Each year we learn more about the best approaches to caring for our Medicare patients, and one of the big lessons learned is that partnering with the federal government on innovative payment models can make significant improvements in the health care system.

David Torchiana, MD President and CEO of Partners HealthCare

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 help patients navigate the complex health care system. PHM provides more information to patients - helping them make the best possible health care decisions.  

To achieve this, Partners has implemented PHM activities across all phases of care delivery.  In primary care, Partners is transforming practices into ‘Patient-Centered Medical Homes,’ where 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), which assigns nurse care managers to oversee complicated and chronically ill patients with multiple medical conditions, such as diabetes or heart disease. The iCMP program helps keep these high-risk individuals healthier and lowers the overall costs for them by preventing avoidable hospital visits.

Other PHM initiatives include virtual visit technology and remote monitoring devices that improve care delivery and better monitor patients with acute illness from home.  For patients who see multiple physicians, Partners is developing programs to assure that care is better coordinated between primary care and specialty care.  For more information on Partners efforts click here.

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.