Partners HealthCare, one of just 32 Pioneer Accountable Care Organizations (ACO) in the nation, has successfully lowered health care cost growth among approximately 52,000 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 the first year of the initiative, Partners HealthCare was successful in slowing the rate of cost growth by approximately 3% as compared with the reference trend that Medicare used to measure Partners’ performance. This translates into approximately $14.4 million in shared savings that Partners will receive from Medicare. Under the Pioneer ACO Model, these savings are shared equally between the federal government and Partners.

Even more importantly, the data shows that Partners delivered extremely high quality care to Medicare patients at the same time that these savings were achieved. Partners exceeded national averages in virtually every quality indicator that the federal government tracked and maintained an extremely low rate of mortality.

“As health care evolves in this country, we have an obligation to ensure that we deliver the best value possible to our patients and their families,” said Gary L. Gottlieb, MD, President and CEO of Partners HealthCare.  “These results show that it is possible to slow health care cost growth, while delivering high quality care.  We are confident that this Pioneer ACO initiative can provide a blueprint for the rest of the nation to follow.”

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 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.

“While we initially saw some risks in joining the Pioneer ACO Model, it is hard to overstate the investment and the commitment this system has made to address the issue of value in health care,” said Timothy Ferris, MD, Vice President for Population Health Management at Partners HealthCare. “Our longstanding partnership and experience with CMS, which dates back to 2006, has helped us achieve these first year results.  As encouraging as these results are, it is important to bear in mind that there is much hard work ahead of us in order to sustain this level of success.”

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 health care 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.

Partners HealthCare is an integrated health system founded by Brigham and Women’s Hospital and Massachusetts General Hospital.  In addition to its two academic medical centers, the Partners system includes community and specialty hospitals, a managed care organization, community health centers, a physician network, home health and long-term care services, and other health care entities. Partners HealthCare is committed to patient care, research, teaching, and service to the community. Partners is one of the nation’s leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School.  Partners HealthCare is a non-profit organization.