Quality Partners ACO to participate in Medicare Shared Savings Program

More than 25,000 Delaware Medicare beneficiaries will benefit from an innovative, highly coordinated, quality-driven approach to care as the Christiana Care Quality Partners Accountable Care Organization (ACO) began Jan. 1 as an approved Shared Savings Program (MSSP) participant with Medicare.

In an innovative statewide partnership, the Quality Partners ACO Shared Savings Program brings together physicians, three of Delaware’s leading health systems – Bayhealth Medical Center, Christiana Care Health System and Nanticoke Health Services – and Westside Family Healthcare, a federally qualified health center. 152 primary care physicians and other health care providers form the base of the ACO team that will set out on a new way of delivering care aimed to lower growth in health care costs while putting Medicare beneficiaries first.

Launched by Medicare to advance the Affordable Care Act, the MSSP facilitates coordination and cooperation among providers both to improve the quality of care for Medicare beneficiaries and to reduce unnecessary costs. Its three-part aim:

• Better care for individuals.
• Better health for our Medicare community.
• Lowering growth in expenditures.

“This approval from Medicare enables Delaware to take our next step into population health and provide outstanding high quality, safe and effective care that is affordable and valued by those we serve,” said Janice E. Nevin, M.D., MPH, Christiana Care’s president and chief executive officer.

“New day” in health care delivery

This new, more integrated, quality-driven approach means care starts at the moment the relationship is established between the physician and the Medicare beneficiary, and not simply in response to symptoms.

“It’s about providing proactive care coordination outside the walls of the hospital buildings, improving access to care and smoothing transitions. The ACO expects to better coordinate care for our members, especially those who have more significant needs due to multiple or severe chronic conditions,” said Douglas Azar, senior vice president, The Medical Group of Christiana Care and Network Operations and executive director Christiana Care Quality Partners and Christiana Care Quality Partners ACO.

The Shared Savings Program is strategically more cost-effective and participating providers are rewarded for outstanding quality and clinical indicators, he said, but, ultimately and more importantly, the accountability leads to better care both for individuals and for populations of people living with chronic conditions.

“It’s a new day in health care,” said Gary Siegelman, M.D., MSc., CPE, senior vice president and chief medical officer of Bayhealth Medical Center. “The tide has turned from an era when hospitals and doctors see patients predominately when they are sick. Things matter before a Medicare beneficiary becomes a patient. We are proactively meeting individual needs, enhancing overall health and taking account for clinical quality and expense for caring for a particular population.”

“We are thrilled to be a vital partner in this statewide ACO,” said Steven A. Rose, RN, MN, president & CEO of Nanticoke Health Services. “Our participation will continue to connect Western Sussex County residents with resources across the state.”

“This innovative partnership puts the Medicare beneficiary at the center of care,” said Tom Stephens, M.D., chief medical officer at Westside Family Healthcare. “By proactively coordinating care, attending carefully to care transitions between providers and greater use of information technology, we can improve patient outcomes and the patient experience.”

Nothing changes, everything changes

“Those whose physicians are part of the new Shared Savings Program should see little difference in terms of process,” said Alan Greenglass, M.D., president of Christiana Care Quality Partners ACO and senior vice president of Network Development. “They will continue established relationships with primary care providers and specialists. The Medicare approach is built on patient choice and an exceeding amount of flexibility.” This choice and flexibility exists currently under Medicare and this aspect does not change, he said.

A unique aspect of the Quality Partners ACO is Care Link, Christiana Care’s information technology-enabled care coordination network that works directly with physicians to support their patients. Care Link harnesses an information technology platform that integrates available sources of a person’s health data so care providers have real-time access to the information they need to address clinical, behavioral, social and other needs that may affect someone’s ability to achieve optimal health and wellness.

“Armed with comprehensive information and care coordination support, physicians will have the tools to drive comprehensive changes in the member’s care plan with the potential to significantly improve clinical indicators and health outcomes,” said Daniel Elliott, M.D., MSCE, FACP, medical director of Christiana Care Quality Partners ACO.

A far shift from the days when patient volume signaled success for physicians and health systems, the new Shared Savings Program rewards ACOs that lower their growth in health care costs while meeting performance standards on 33 measures of quality of care and clinical indicators.

“We are firmly convinced the Quality Partners ACO will benefit our physician colleagues and provide greater value to the Medicare population we are so privileged to serve,” said Dr. Nevin. “Thanks to this strong partnership with respected community colleagues, we are confident this will be an exciting and transformative effort for our community, and that, together, we will provide high-value care to our Medicare patients.”