Conference Coverage

Feds: 89 New ACOs Up and Running as of July 1


 

Another 89 accountable care organizations had opened their doors for business as of July 1, the Health and Human Services department announced July 9.

That brings the total to 154 groups that have agreed to be held accountable for improving the quality of care they provide while simultaneously reducing costs, including 32 participating in the pioneer ACO model announced in December, as well as six physician group practice transition demonstration organizations that began in early 2011.

Some 2.4 million Medicare beneficiaries in 40 states and Washington, D.C., now are cared for by an ACO, the department announced.

At least 400 more organizations have said they will apply to become an ACO when the Centers for Medicare and Medicaid Services (CMS) begins in August accepting applications for 2013, according to Jonathan Blum, principal deputy administrator for CMS and director of its Center for Medicare.

In a briefing with reporters, Mr. Blum did not directly address whether the program could be hurt by expected attempts to defund the Affordable Care Act. Instead, he said, "This is a program that is going to grow substantially over time."

ACOs are meant to be led by physicians, working in conjunction with hospitals and other providers to deliver more efficient and better-quality care. "We really see this being led by the physician community to improve patient care," Mr. Blum said.

Of the 89 new ACOs, "almost half are physician-driven organizations serving fewer than 10,000 beneficiaries, demonstrating that smaller organizations are interested in operating as ACOs," according to a CMS statement.

However, the requirement that an ACO serve at least 5,000 Medicare beneficiaries continues to be a difficult hurdle for physician groups that would otherwise like to participate, said Mr. Blum.

The ACO effort is also known as the Medicare Shared Savings Program. The organizations that agree to participate are given the opportunity to share in whatever savings are generated. CMS estimates that the government’s savings from the program could be up to $940 million over 4 years.

One of the newest ACOs is the Westmed Medical Group, a Westchester County, New York–based physician-owned and managed multispecialty group practice that was founded in 1996, and includes 225 physicians and 1,000 employees.

Dr. Simeon Schwartz, president and CEO, said that each of group’s nine sites generally offers primary care; surgical, specialty, radiology, and lab services; and urgent care.

Westmed expects to generate savings of 5%-10% over the course of the group’s 3-year contract, mostly by shifting care from the inpatient to the outpatient setting through better coordination, he said at the press briefing. He added that providing urgent care – keeping patients out of the emergency department – is another way to save money.

In a statement, HHS Secretary Kathleen Sebelius said that having better care coordination will be one of the keys to generating savings.

"We applaud every one of these doctors, hospitals, health centers, and others for working together to ensure millions of people with Medicare get better, more patient-centered, coordinated care," she said.

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