Atrius Health Chosen in Competitive Process for New Medicare ACO Program
New Model Designed to Offer Better Care to Beneficiaries through Partnership with Medicare
BOSTON— 12/19/11 — Atrius Health, the largest independent non-profit physician group in Massachusetts, today announced it has been selected to participate in the Pioneer Accountable Care Organization (ACO) model, a transformative new initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center.
Today’s announcement was the culmination of a competitive selection process that began in May with the national release of a Request for Applications from CMS. Atrius Health was selected based on its demonstrated capabilities to offer high quality, coordinated care.
Through the Pioneer ACO Model, Atrius Health will work with CMS to provide Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination.
“We at Atrius Health are honored by the opportunity to work directly with Medicare to expand the ACO model of care delivery that has made it easier for our patients to be healthier,” said Dr. Gene Lindsey, CEO of Atrius Health. “People may not realize we have been functioning like an ACO for years, but our patients see the benefits every day in terms of more time with their physicians, access to teams of doctors and clinical experts, and better coordination with specialists and hospitals.”
The Pioneer ACO Model is designed to encourage the development of ACOs, which are groups of doctors and other healthcare providers who work together to provide high quality care for their patients. As one in a diverse group of leading-edge health care organizations from around the country, Atrius Health was chosen specifically by the Innovation Center to test the effectiveness of several models of payment in helping organizations make a rapid transition to higher quality care at a lower cost to Medicare.
“These Pioneer ACOs represent our nation’s leaders in health systems innovation, providing highly coordinated care for patients at lower costs,” said Marilyn Tavenner, Acting Administrator of CMS. “The Atrius Health groups have demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them,” Tavenner said.
CMS will use robust quality measures and other criteria to measure how ACOs provide beneficiaries with a positive patient experience and better health outcomes. Those ACOs who achieve high quality performance and reduce growth in Medicare expenditures for the same patient population may receive incentives from CMS.
Unlike a managed care plan, Medicare beneficiaries will not be 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. Beneficiaries do not enroll in the Pioneer ACO model, but instead are assigned to a practice based on their prior history of medical care.
Initially, the following Atrius groups will participate: Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates, South Shore Medical Center, and Southboro Medical Group.
The Pioneer ACO Model is one of a number of initiatives developed by the new Innovation Center. The Innovation Center was created by the Affordable Care Act to test new models of health care delivery and payment.
Background on Atrius Health
Atrius Health, a nonprofit alliance of six multi-specialty medical groups, was created in 2004 to enable collaboration on new and better ways of delivering care while maintaining an emphasis on care for the local community. The 1000 physicians and over 1425 other healthcare professionals in these groups serve almost 1,000,000 adult and pediatric patients from about 50 sites across Eastern and Central Massachusetts. The Atrius Health Pioneer ACO is comprised of five of the six medical groups: Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates, South Shore Medical Center, and Southboro Medical Group. Reliant Medical Group joined Atrius Health in October 2011 and will consider participation in the Pioneer ACO for future years.
The Atrius Health groups work closely with leading academic medical centers and community hospitals to coordinate care across the continuum for their patients. The Atrius Health groups have been leaders nationally in their advanced use of health information technology (including a patient portal for secure electronic communication), chronic disease management, clinical pharmacy programs, Lean care improvement, and innovative ways of delivering care such as shared medical appointments.
For more information about the Pioneer ACO Model, visit the Pioneer ACO website.
The Pioneer ACO Model is one of several initiatives underway at CMS designed to encourage the formation of ACOs. For more information, visit www.cms.gov/aco.
For more information about the Innovation Center, visit innovations.cms.gov.