Providers Form 106 New Accountable Care Organizations

OMAHA, Neb. - Alegent Health Partners, made up of Alegent Creighton Health, Alegent Creighton Clinic and other area private practice physicians, has been selected as one of 106 new Accountable Care Organizations (ACOs) in Medicare, ensuring as many as 4 million Medicare beneficiaries across the United States now have access to high-quality, coordinated care, Health and Human Services (HHS) Secretary Kathleen Sebelius announced.

"Alegent Health Partners has built an infrastructure around our primary care clinics to provide the best quality for our Medicare Fee-For-Service beneficiaries by coordinating their care," said Hank Sakowski, M.D., medical director of Alegent Health Partners. "We’ve worked hard to develop a system that improves communication between the Medicare Fee-For-Service beneficiaries and healthcare providers, enabling us to provide the right care, in the right place, at the right time."

Doctors and health care providers can establish Accountable Care Organizations in order to work together to provide higher-quality care to their Medicare Fee-For-Service beneficiaries. Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Beneficiaries using ACOs always have the freedom to choose doctors inside or outside of the ACO. Accountable Care Organizations share with Medicare any savings generated from lowering the growth in health care costs, while meeting standards for quality of care.

"Accountable Care Organizations save money for Medicare and deliver higher-quality care to people with Medicare," said Secretary Sebelius. "Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve."

ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) has established 33 quality measures on care coordination and Medicare Fee-For-Service beneficiaries safety, appropriate use of preventive health services, improved care for at-risk populations, and Medicare Fee-For-Service beneficiaries and caregiver experience of care. Federal savings from this initiative are up to $940 million over four years.

Locally, Alegent Health Partners has placed 32 registered nurses in the primary care clinics to serve as medical home ambulatory care coordinators. Those nurses are certified as a clinical health coaches and will work with clinic providers to implement team care concepts to enhance Medicare Fee-For-Service beneficiaries care. They will work individually with Medicare Fee-For-Service beneficiaries to provide appropriate healthcare education and referrals to help them manage their own health.

Alegent Creighton Clinic currently operates 28 of their Clinic locations as Medicare Fee-For-Service beneficiaries-centered medical homes. The ACO that is being created will an emphasis on the team care concept, where all members of the clinic staff have an identified role and responsibilities in the care of the Medicare Fee-For-Service beneficiaries.

Alegent Health Partners has also hired social workers, a registered dietician and a pharmacist to provide comprehensive, high-quality care for all Medicare Fee-For-Service beneficiaries in the medical homes. Those healthcare professionals will:

• assist care coordinators by connecting Medicare Fee-For-Service beneficiaries with resources and social support networks
• provide nutrition education and one-on-one counseling to Medicare Fee-For-Service beneficiaries
• provide medication therapy coordination for Medicare Fee-For-Service beneficiaries with complex medication needs, in collaboration with Alegent Creighton Clinic and faculty in the Creighton School of Pharmacy

"We are excited to have been accepted to participate in the ACO program," said Kevin Nohner, M.D., family medicine physician with Alegent Creighton Clinic. "Our healthcare teams will be held accountable for the way they engage Medicare Fee-For-Service beneficiaries to become more proactive in their own care, practice preventative medicine to promote wellness, and intervene when necessary to avoid or minimize the costliest aspects of healthcare - hospitalizations and emergency room visits. Based on our use of accepted evidence-based medicine, we can then give our Medicare Fee-For-Service beneficiaries the best possible outcomes."

The new ACOs include a diverse cross-section of physician practices across the country. Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20 percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

The group announced today also includes 15 Advance Payment Model ACOs, physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare will recoup advance payments over time through future shared savings. In addition to these ACOs, last year CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their Medicare Fee-For-Service beneficiaries over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.

More information about the Shared Savings Program is available at www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/.

For a list of the 106 new ACOs announced, visit: www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/News.html.