Bellin Health Partners Entering Next CMS ACO Model
Nation-Leading Partnership Paves way for Independent Participation
Bellin Health Partners will participate in the Next Generation Accountable Care Organization (ACO) Model, the Centers for Medicare & Medicaid Services’ (CMS) newest ACO model. For the last three years, Bellin Health has participated in CMS’ Pioneer ACO Model through a collaboration with ThedaCare known as Bellin-ThedaCare HealthCare Partners. This partnership received national recognition for generating $14 million in savings – while simultaneously producing the highest quality and lowest cost in the country among Medicare ACOs.
The Green Bay-based health system will participate in the new model as an ACO known as Bellin Health Partners, which is structured to include the health system’s resources along with employed physicians and independent physicians affiliated with Bellin.
“Bellin takes great pride in providing high-quality care, managing costs and creating a positive patient experience,” said George Kerwin, Bellin Health president and CEO. “It’s why we have delivered outstanding results through Pioneer – and why we will be successful in Next Generation.”
CMS describes the Next Generation ACO Model as an initiative for ACOs that are experienced in coordinating care for populations of patients that will allow organizations like Bellin Health Partners to assume higher levels of financial risk and reward than are currently available under the Pioneer Model, the Medicare Shared Savings Program and other CMS ACO models. Since the passage of the Affordable Care Act, more than 477 Medicare ACOs have been established in 49 states, serving nearly 8.9 million beneficiaries.
Twenty-one ACOs from across the nation will participate in the Next Generation ACO Model. The initial commitment is three years, with two optional one-year extensions allowed. Bellin Health Partners is included in the first group of participating organizations that began on Jan. 1, 2016.
“In essence, we are graduating from Pioneer. Next Generation offers greater opportunities for patient engagement, including increased care coordination, home visits and using video conferencing to connect patients with specialists,” said Kerwin. “What’s most exciting is how our participation in these models benefits all of our patients because we take what we learn and apply it to our system as a whole. We are at the forefront of transforming healthcare.”
Bellin-ThedaCare HealthCare Partners experienced great success after being selected in 2011 as one of the 32 organizations to join the Pioneer Program, which began the following year. In its three years of participation, the partnership generated $7.6 million, $3.2 million and $3.1 million in savings for Medicare, respectively.
At the same time, Bellin-ThedaCare HealthCare Partners was the indisputable leader in cost and quality while caring for the 20,000 Medicare beneficiaries in Northeast Wisconsin assigned to it through the Pioneer program. Among the participants, Bellin-Theda had the highest quality score for the 33 metrics measured by CMS in each of the three years. Within that same time frame, the ACO partnership held the per-beneficiary costs for delivering care lower than any other participant in the national program.
“Success is defined as the ability to simultaneously improve quality, control cost and deliver a satisfactory patient experience. One cannot come at the expense of another,” said Kerwin. “That’s what people in the communities we serve can expect of us and that’s what we’ll continue to deliver to impact healthcare in this region.”
Accountable Care Organizations are comprised of groups of doctors, hospitals and other healthcare providers and suppliers who come together to provide coordinated, high-quality care at lower costs for patients. In shared savings models, targets are set for healthcare costs and quality for a defined population of patients, with an incentive for ACOs to receive a portion of savings if the amount spent is lower than projected and quality benchmarks are achieved. Risk is also assumed in participation in shared savings models, with the potential to receive lesser reimbursement if costs are higher than projected or quality measures are not met.
About Bellin Health
Bellin Health, www.bellin.org, is an integrated healthcare delivery system based in Green Bay, Wisconsin. It has serviced people in Northeast Wisconsin and Michigan’s Upper Peninsula since 1908. Bellin Health has more than 3,600 employees and is known for its emphasis on preventive healthcare and is the region’s leader in cardiac, orthopedics, sports medicine, digestive health, mental health and primary care medicine. It is comprised of Bellin Hospital, Bellin Psychiatric Center, 31 Bellin Health primary care physician clinics, and several retail health clinics known as Bellin Health FastCare. Bellin also operates Bellin Health Oconto Hospital, a critical care access hospital in Oconto, Bellin Fitness and Bellin College.