AtlantiCare Joins New Accountable Care Collaborative

AtlantiCare today announced that it will work as part of a new collaborative to design and implement an Accountable Care Organization (ACO) in New Jersey. ACOs are defined as a group of providers coming together to accept accountability for a defined patient population’s care. ACOs are designed to keep patients healthy and out of intensive care settings, while simultaneously shifting reimbursements to be based on quality outcomes and efficiencies.
Premier, a healthcare performance improvement alliance that announced the collaboration today in Washington, D.C. Nineteen health systems with more than 70 hospitals, a broad variety of payer contracts and partnerships with thousands of physicians will participate in the ACO Implementation Collaborative. Participating health system members are located in 15 states, covering urban, rural and suburban populations that range in size from 4,000 to 7.5 million residents.
AtlantiCare, the only organization in New Jersey participating in the Premier collaborative, expects to be among the first in the nation to create ACOs in the market, accepting increased accountability for the care it delivers to patients by improving coordination, efficiency, and quality of care and increasing patient satisfaction.
“AtlantiCare is inspired by the elusive goal of achieving optimal health for all members of the community by focusing on preventing illness and injury and the effectively managing existing health risks and chronic disease,” said AtlantiCare Vice President for Health Engagement Katherine Schneider, MD. “Through the Premier ACO collaboration we look forward to enhancing the work we’re doing around patient-centered health homes, learning from other organizations and developing new models of care that will benefit patients not only in our region, but also across the country.”
Collaborative members also will build the critical components of accountable care, including:
Patient-centered health homes that deliver primary care and manage health and wellness.
New approaches to primary, specialty and hospital care to reward care coordination, efficiency and productivity.
Tightly integrated relationships with specialists, ancillary providers and hospitals so they are similarly focused and aligned to achieve high-value outcomes.
Provider/payer partnerships and reimbursement models that incent improved outcomes, rewarding value over volume.
Population health information infrastructure, including health information exchanges, to enable care coordination across provider networks.
To help members develop the capabilities necessary to form ACOs, Premier has created two collaborative opportunities for members. The ACO Implementation Collaborative is designed for health systems able to pursue ACOs for patients today, leveraging existing payer partnerships and a tightly aligned, engaged physician network. The ACO Readiness Collaborative is designed for health systems that must first develop the organization, skills, team and operational capabilities necessary to become ACOs and ultimately join the Implementation Collaborative. AtlantiCare is a member of the Implementation Collaborative.
Members of the collaborative include:
Aria Health; Philadelphia, Pennsylvania
AtlantiCare; Egg Harbor Township, New Jersey
Baystate Health; Springfield, Massachusetts
Billings Clinic; Billings, Montana
Bon Secours St. Francis Health System, Inc.; Greenville, South Carolina, and Bon Secours Richmond Health System; Richmond, Virginia – part of Bon Secours Health System, Inc.
CaroMont Health; Gastonia, North Carolina
Fairview Health Services; Minneapolis, Minnesota
Geisinger Health System; Danville, Pennsylvania
Heartland Health; St. Joseph, Missouri
Methodist Medical Center of Illinois; Peoria, Illinois
North Shore-LIJ Health System; Long Island, New York
Presbyterian Healthcare Services; Albuquerque, New Mexico
Saint Francis Health System; Tulsa, Oklahoma
Southcoast Hospitals Group; Fall River, Massachusetts
SSM Health Care; St. Louis, Missouri
Summa Health System, Akron, Ohio
Texas Health Resources; Arlington, Texas
University Hospitals; Cleveland, Ohio
“By embarking on this effort to transform the quality, efficiency and satisfaction of patient care, AtlantiCare is putting patients first and creating a successful new model that others will seek to learn from and emulate,” said Premier President and CEO Susan DeVore. “The work required to become an ACO will be extremely challenging and AtlantiCare deserves tremendous credit for its commitment to implementing necessary reforms that will help ensure our system is sustainable and highly effective. AtlantiCare is a true marketplace leader, who in taking this step, will have a positive effect on community health.”
The Premier ACO Collaborative is basing the definition of value — and, thus, the accountability for delivering it — on the Triple Aim approach the Institute for Healthcare Improvement uses. The Triple Aim requires providers to simultaneously focus on optimizing quality and outcomes of care; patient satisfaction with care, patient engagement in their care and overall patient involvement in working toward optimal health outcomes; and efficiency, typically measured as a per member, per month cost of care.
Collaborative members will next determine how successful their efforts have been by measuring the overall health of their communities, patient satisfaction and the cost of care. Collaborative participants may be the first to apply for ACO contracts with the Centers for Medicare & Medicaid Services (CMS) program to cover additional patients as early as 2012. This is the date CMS is required to develop an ACO shared savings program under the recently passed healthcare reform law.
“AtlantiCare has established a new construct in its continuing pursuit of excellence in healthcare delivery,” said AtlantiCare President and CEO David Tilton. “It is one that reduces cost yet improves both quality and accessibility of care. We believe it is time to re-examine and challenge the fundamental principles upon which the healthcare industry has been built. We are excited about doing so with our ACO partners and locally with employers and other partners in our community. We look forward to the changes we will make and the impact they will have in helping us build a healthier community.”
About AtlantiCare
AtlantiCare is committed to building healthy communities through partnerships with local organizations that share its interest in health (i.e., employers, unions, payors, physicians, churches, schools, community organizations, etc.) AtlantiCare’s primary service offering of Healthcare Delivery, integrated with the complementary and strategic service offerings of Health Information and Health Engagement, formerly known as Epidemic of Health (EOH), focuses on delivering value at every stage of an individual’s health (healthy, at-risk, episodically ill or chronically ill). Together, these services offer the elements necessary to achieve, maintain or return each member of the community to optimal health.
AtlantiCare’s more than 5,000 staff and more than 600 physicians provide services for the community in nearly 60 locations. AtlantiCare includes AtlantiCare Regional Medical Center (ARMC), a 589-bed teaching hospital providing a full range of inpatient and outpatient services from perinatology to geriatrics. ARMC focuses primarily on the physical healthcare of the community. AtlantiCare Behavioral Health (ABH) offers mental and behavioral health services. ABH’s main services include a psychiatric intervention program; inpatient psychiatric care; adult and child partial care programs; adult, child and adolescent health behavioral services and school-based interventional programs. AtlantiCare Health Services (AHSvs) offers a wide variety of healthcare and wellness services outside
the hospital setting designed to complement ARMC and ABH services. They include the AtlantiCare Surgery Center (ASC), Clinical Labs, Urgent Care centers, Hospice Program, Home Care, Family and Internal Medicine, Occupational Medicine, Childcare and Early Learning Centers, and Mission HealthCare (a Federally Qualified Health Center caring for the homeless). AtlantiCare also includes InfoShare, its information technology entity. To learn more about AtlantiCare call the AtlantiCare Access Center at 1-888-569-1000 or visit www.atlanticare.org.
About Premier
A 2006 Malcolm Baldrige National Quality Award recipient, Premier is a performance improvement alliance of more than 2,300 U.S. hospitals and 66,000-plus other healthcare sites working together to achieve high quality, cost-effective care. Owned by not-for-profit hospitals, Premier maintains the nation’s most comprehensive repository of clinical, financial and outcomes information and operates a leading healthcare purchasing network. A world leader in helping deliver measurable improvements in care, Premier works with the Centers for Medicare & Medicaid Services and the United Kingdom’s National Health Service North West to improve hospital performance. Headquartered in Charlotte, N.C., Premier also has offices in San Diego, Philadelphia and Washington. www.premierinc.com