Providing Better, More Coordinated Care Through Pioneer ACOs
By Richard Gilfillan, Director of the Center Medicare and Medicaid Innovation
Anyone who has multiple doctors probably understands the frustration of fragmented and disconnected care: lost or unavailable medical charts, trouble scheduling an appointment or talking to a doctor, duplicated medical procedures, or having to share the same information over and over with different doctors.
Accountable Care Organizations (ACO’s) are designed to lift this burden from patients, while improving the partnership between patients and doctors in making health care decisions. People with Medicare will have better control over their health care, and their doctors can provide better care because they will have better information about their patients’ medical history and can communicate more readily with a patient’s other doctors. Doctors in ACOs aren’t penalized for spending more time with patients – they’re rewarded for it.
Starting today, provider groups from across the country will get support in providing better, more coordinated health care through an initiative called the Pioneer Accountable Care Organizations (ACO) Model. This initiative will advance the best practices of primary care doctors, specialists, hospitals and other providers in coordinating care for patients with Medicare.
There are 32 leading health care organizations from across the country that will participate in this new initiative made possible by the Affordable Care Act. They represent health system leaders in innovation, providing highly coordinated care for patients at lower costs. This initiative will help some of our nation’s best health care systems become even better.
For example, Sharp Healthcare has taken innovative steps toward engaging patients in their care through a patient portal. In this portal, patients can get information about their care, and easily access information about their health and steps they can take to keep themselves healthy. By empowering patients to know more about their care, Sharp is partnering with their patients to make the best possible decisions about their health.
Medicare beneficiaries aligned with Seton Health Alliance in Central Texas will continue to have access to four After Hours Clinics, where patients can be seen in a clinic setting staffed by physicians after regular hours. Services available 24 hours a day will include phone nurses, online education resources, online appointment requests and online bill-pay.
Under this model, ACO’s take greater risk and get greater rewarded than in the Medicare Shared Savings Program for how well they’re able to improve the health of their Medicare patients and lower health care costs. We’ll test several different models to determine which best meets the goals of better care and reduced growth in costs.
Selected Pioneer ACOs include physician-led organizations and health systems, urban and rural organizations, and organizations in various geographic regions of the country, representing 18 States and the opportunity to improve care for 860,000 of Medicare beneficiaries.
For more information about the CMS Innovation Center, visit innovations.cms.gov.