ACCOUNTABLE CARE ORGANIZATIONS: AN OPPORTUNITY FOR COMMUNITY PHARMACISTS?

Size: px
Start display at page:

Download "ACCOUNTABLE CARE ORGANIZATIONS: AN OPPORTUNITY FOR COMMUNITY PHARMACISTS?"

Transcription

1 ACCOUNTABLE CARE ORGANIZATIONS: AN OPPORTUNITY FOR COMMUNITY PHARMACISTS? PENNSYLVANIA PHARMACIST ASSOCIATION MID-YEAR CONFERENCE FEBRUARY 20, 2015 Christine M. O Leary, PharmD, BCPS DISCLOSURES Christine M. O Leary: No financial disclosures This presentation is intended for educational use only. Nothing in this presentation should be construed as an endorsement of any particular product or service. Review of specific laws or regulations should not be construed as legal advice. The information interpretation/opinions expressed are solely that of the presenter and no other organization/employer. 1

2 Accountable Care Organization Policies Accountable Care Organization Policies 2

3 PROGRAM OBJECTIVES At the completion of this activity, the participant will be able to: Identify the regulations and structure of an Accountable Care Organization (ACO). State the names of current ACOs in Pennsylvania. Recognize the role of community pharmacies in an ACO. Classify opportunities for a community pharmacy to participate in an ACO. Given a case scenario, determine if the community pharmacy qualifies to participate in an ACO. WHAT IS AN ACCOUNTABLE CARE ORGANIZATION? 3

4 DEFINITION OF AN ACO A collection of providers jointly held accountable for achieving measured quality improvements and reductions in spending for a given population of patients across the care spectrum McClellan et al Health Affairs. 2010;29: WHY THE MOVE TO ACCOUNTABLE CARE? Control health care costs Improve health care quality Improve patient satisfaction Achieving the Triple Aim 4

5 WAIT.THIS SOUNDS FAMILIAR DIFFERENCE BETWEEN AN ACO AND AN HMO Accountable Care Organization Responsible for the clinical outcomes across care continuum Health Maintenance Organization Responsible for payment of clinical services Provider lead Not responsible for payment of claims Focused on primary care/prevention Driven by the health plan Responsible for claim payments Focused on controlling costs Patients can go outside the network without penalty Patients are required to use network providers Accountable Care Organizations 101. APhA ACO ISSUE BRIEF SERIES Beis S. Ohio Society of Health-System Pharmacists

6 ATTRIBUTES OF AN ACO Patient-centered Team-based Primary care core Coordinated care Focused on quality THAT S A PATIENT-CENTERED MEDICAL HOME..RIGHT? PCP Practice PCP: Primary Care Provider Image: 6

7 THE MEDICAL NEIGHBORHOOD ACO PCMH Pharmacy Specialist Hospital/Health System PCMH PCMH: Patient-centered medical home Image: Beis S. Ohio Society of Health-System Pharmacists TRUE OR FALSE? Only organizations certified by the Center for Medicare and Medicaid (CMS) can be ACOs? A. True B. False 7

8 TRUE OR FALSE? Only organizations certified by the Center for Medicare and Medicaid (CMS) can be ACOs? A. True B. False TYPES OF ACOS Pioneer ACO Medicare Share Savings Programs (MSSP) Commercial ACO Medicaid ACO SK&A Market Insight Report Cegedim. 8

9 Pioneer ACO* MSSP Commercial ACO Medicaid ACO Public contract with CMS (length varies) Upside & downside payment model Pre-determined universal quality metrics Patient population: Medicare Beneficiaries (minimum 5,000) *Original # of Pioneer ACOs: 32; currently 19 (Jan2014) Public contract with CMS (3 years) Upside-only or Upside & downside payment model Pre-determined universal quality metrics Patient population: Medicare beneficiaries (minimum 5,000) Private contract with a health plan (1 year; ex: IBX, Aetna, Cigna) Payment model: created by health plan, agreed upon with provider Quality metrics vary from plan-toplan Patient population: plan or provider discretion (5,000-10,000) Public contract with state Medicaid (length varies) Payment model: determined by state Quality metrics vary but attempts being made to align with CMS Patient population: Medicaid beneficiaries (varies) SK&A Market Insight Report Cegedim ACO Financing Models. APhA ACO ISSUE BRIEF SERIES Requirement Public ACO (MSSP) Commercial ACO (Private) Time Commitment 3 years 1 year Board Requirements Yes; physician majority No PCMH/ACO Accreditation No Yes; either CMS, URAC*, or NCQA ± Quality Metrics Yes; 33 determined by HHS Yes; determined through payer and provider negotiations *URAC: Utilization Review Accreditation Commission; ± NCQA: National Committee for Quality Assurance Accountable Care Organizations 101. APhA ACO ISSUE BRIEF SERIES 9

10 WHICH OF THE FOLLOWING STATEMENTS IS TRUE? A. A practice must be a certified Patient-Centered Medical Home to be part of an Accountable Care Organization? B. A community pharmacy must be accredited by a national organization to participate in medication aspects of an accountable care organization? C. An accountable care organization can be created by a health plan contracting with a group of providers. D. An accountable care organization payment contract must either public or private; it cannot be both. CAN THEY DO BOTH? 2013 estimates by Leavitt Partners Accountable Care Organizations 101. APhA ACO ISSUE BRIEF SERIES 10

11 ACO PAYMENT MODELS Full Capitation Partial Capitation Bundled Payment Shared Savings ACO Financing Models. APhA ACO ISSUE BRIEF SERIES SHARED SAVINGS Upside only: model no penalty for losses Upside & downside model : penalty for losses ACO Financing Models. APhA ACO ISSUE BRIEF SERIES 11

12 IT S ABOUT SAVINGS AND QUALITY GOAL OF AN ACO Effective population health management Effective management of cost associated with care Population health management: ACOs are response for the quality outcomes of all patients within their patient population (aka panel of patient, attributable lives ) ACO Financing Models. APhA ACO ISSUE BRIEF SERIES 12

13 QUALITY MEASURES 33 CMS quality measures 4 domains: Patient/Caregiver Experience Care Coordination/Patient Safety Preventative Health At-Risk Populations CMS: Center for Medicare and Medicaid Services Experience; Coordination/Safety 1. Getting timely care, appointments & 2. information 3. Physician communication 4. Physician rating 5. Access to specialists 6. Health promotion & education 7. Shared decision making 8. Health status/functional status 9. Risk Standardized, All Condition Readmissions 10. Admissions: COPD/Asthma in older adults 11. Admissions: CHF 12. Percent of PCPs who qualify for electronic health record program incentive payment 13. Medication reconciliation following discharge 14. Screening for fall risk Preventative Health 14. Influenza immunization 15. Pneumococcal immunization 16. Adult weight screening & follow-up 17. Tobacco use assessment & cessation intervention 18. Depression screening 19. Colorectal cancer screening 20. Mammography screening 21. Hypertension screening At-Risk Populations Diabetes composite (22-26, all or nothing) 22. Hgb A1C 23. LDL 24. BP 25. Tobacco use 26. ASA 27. Diabetes: Hgb A1C control 28. Hypertension: BP control 29. IVD*: Complete lipid panel & LDL in control (LDL < 100) 30. IVD*: ASA or antithrombotic use 31. HF: β-blocker therapy for left LVSD ± CAD composite (32-33, all or nothing) : 32. Drug therapy for lowering LDL 33. ACE/ARB therapy for diabetes or LVSD *Ischemic vascular disease; ±Left ventricular systolic dysfunction Source: 13

14 Experience; Coordination/Safety 1. Getting timely care, appointments & 2. information 3. Physician communication 4. Physician rating 5. Access to specialists 6. Health promotion & education 7. Shared decision making 8. Health status/functional status 9. Risk Standardized, All Condition Readmissions 10. Admissions: COPD/Asthma in older adults 11. Admissions: CHF 12. Percent of PCPs who qualify for electronic health record program incentive payment 13. Medication reconciliation following discharge 14. Screening for fall risk Preventative Health 14. Influenza immunization 15. Pneumococcal immunization 16. Adult weight screening & follow-up 17. Tobacco use assessment & cessation intervention 18. Depression screening 19. Colorectal cancer screening 20. Mammography screening 21. Hypertension screening *Ischemic vascular disease; ±Left ventricular systolic dysfunction At-Risk Populations Diabetes composite (22-26, all or nothing) 22. Hgb A1C 23. LDL 24. BP 25. Tobacco use 26. ASA 27. Diabetes: Hgb A1C control 28. Hypertension: BP control 29. IVD*: Complete lipid panel & LDL in control (LDL < 100) 30. IVD*: ASA or antithrombotic use 31. HF: β-blocker therapy for left LVSD ± CAD composite (32-33, all or nothing) : 32. Drug therapy for lowering LDL 33. ACE/ARB therapy for diabetes or LVSD Experience; Coordination/Safety 1. Getting timely care, appointments & 2. information 3. Physician communication 4. Physician rating 5. Access to specialists 6. Health promotion & education 7. Shared decision making 8. Health status/functional status 9. Risk Standardized, All Condition Readmissions 10. Admissions: COPD/Asthma in older adults 11. Admissions: CHF 12. Percent of PCPs who qualify for electronic health record program incentive payment 13. Medication reconciliation following discharge 14. Screening for fall risk Preventative Health 14. Influenza immunization 15. Pneumococcal immunization 16. Adult weight screening & follow-up 17. Tobacco use assessment & cessation intervention 18. Depression screening 19. Colorectal cancer screening 20. Mammography screening 21. Hypertension screening *Ischemic vascular disease; ±Left ventricular systolic dysfunction At-Risk Populations Diabetes composite (22-26, all or nothing) 22. Hgb A1C 23. LDL 24. BP 25. Tobacco use 26. ASA 27. Diabetes: Hgb A1C control 28. Hypertension: BP control 29. IVD*: Complete lipid panel & LDL in control (LDL < 100) 30. IVD*: ASA or antithrombotic use 31. HF: β-blocker therapy for left LVSD ± CAD composite (32-33, all or nothing) : 32. Drug therapy for lowering LDL 33. ACE/ARB therapy for diabetes or LVSD 14

15 WHAT IS THE ACO ACTIVITY IN PENNSYLVANIA? WHICH OF THE FOLLOWING ORGANIZATIONS IS A COMMERCIAL ACO IN PENNSYLVANIA? A. River Health ACO, LLC B. Wellspan Health C. Keystone ACO D. Delaware Valley ACO 15

16 MSSP ACOs in Pennsylvania ACO Name Areas Covered Website Accountable Care Clinical Services, PC CA, CT, IA, MA, PA Allegiance ACO NJ, PA Atlantic ACO NJ, PA Chautauqua Region Associated Medical Partners, LLC NY, PA Crystal Run Healthcare ACO, LLC NY, PA bout-us/aco.aspx Delaware Valley ACO NJ, PA Greater Baltimore Health Alliance MD, PA Keystone ACO NY, PA Lancaster General Health Community Care Collaborative, LLC PA LHS Health Network, LLC NJ, PA Maryland Accountable Care Organization of Western MD LLC MD, PA, WV River Health ACO,LLC PA Saint Vincent Healthcare Partners THP-Meritus ACO, LLC NY, PA MD, PA, WV Source: Commercial ACOs in Pennsylvania* ACO Name Partner Location in PA Humana s Accountable Care Hospital/Physician s of Continuum St. Lukes University Health Network Allentown, Bethlehem Penn Medicine Independence Blue Cross Philadelphia Renaissance Health Network Keystone Health Plan East Independence Blue Cross Wayne Wellspan Health Aetna York *List not all inclusive 16

17 CAN COMMUNITY PHARMACIES GET A STAKE IN ACOS? ABSOLUTELY! But we need to know the Value Proposition AND how to communicate it 17

18 KEY CONSIDERATIONS Drivers of an ACO s medication management approach Objective data to support inclusion of community pharmacies in ACOs Strategic communication ALL OF THE FOLLOWING ARE GENERALLY RECOGNIZED AS DRIVERS OF AN ACOS MEDICATION MANAGEMENT APPROACH, EXCEPT: A. Type of ACO B. Maturity of the ACOs development C. Primary focus of the ACO D. Pharmacist : Physician staff ratio 18

19 KEY CONSIDERATIONS Drivers of an ACO s medication management approach Type of ACO Maturity Primary focus Objective data to support inclusion of community pharmacies in ACOs Strategic communication Who to talk to What to say How to say it KEY CONSIDERATIONS Drivers of an ACO s medication management approach Type of ACO Maturity Primary focus Objective data to support inclusion of community pharmacies in ACOs Strategic communication Who to talk to What to say How to say it 19

20 DRIVERS OF AN ACO S MEDICATION MANAGEMENT APPROACH Type of ACO Medication costs in the risk-bearing contracts? Medication-related quality measures? Maturity Newly formed? Established? Hiring pharmacists vs contracting Primary focus Readmissions Care Transitions Chronic Disease Management ACO Financing Models. APhA ACO ISSUE BRIEF SERIES OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Barnett et al, 2009: Analysis of MTM in Community Pharmacies Multistate MTM services in community pharmacies January 1, 2000, through December 31, 2006 Estimated cost savings = $7.1 million Barnett et al. J Manag Care Pharm Jan-Feb;15(1): Amara et al. Hosp Pharm.2014; 49 (3):

21 OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Trinity Pioneer ACO Launched August 2013 Collaboration: Iowa Pharmacy Association, Iowa Health System, Community Pharmacy Foundation, McKesson, NACDS Foundation Partnerships: Outcomes MTM, Collaborative Education Institute OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Trinity Pioneer ACO Pharmacy Structure Trinity Pharmacists Identify High Risk Patients Iowa Health Pharmacists Triage High Risk Patients MTM Community Pharmacist Providers MTM, Med rec, monitor start of high-risk med, document in Outcomes MTM platform 21

22 OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Trinity Pioneer ACO Preliminary Results October 2013 thru June 2014 Total patients served: 349 Total MTM claims: 850 Average 2.4 claims per patient OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Wisconsin Pharmacy Quality Collaborative Principle: Pharmacy Society of Wisconsin Funding: $4.1 million CMS Health Care Innovation Award 3 year grant (July 1, 2012 to June 30, 2015) Goal: reduce health care costs ~ $20 million Aspects: Pharmacies must be accredited Registration, implement standard practices, sign Good Faith Agreement, have at least one WPQCcertified pharmacist onsite, assessments Q6mos 22

23 OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS WPQC Pharmacy Involvement Pharmacies: 338 registered and 317 accredited Pharmacists: 1420 registered and 1215 certified Students: 257 registered and 204 certified WPQC Financial Impact: Pilot program results $5-10 : $1 ROI (Level I services) $2.5-5 : $1 ROI (Level I & Level II services) Current results $5-6 : $1 ROI (Level I & Level II services) OBJECTIVE DATA TO SUPPORT INCLUSION OF COMMUNITY PHARMACIES IN ACOS Independent Pharmacy & Population Health Management (PHM) Pharmacists Caring for Diabetics: a pilot program in Missouri Announced 2013 Collaboration: National Community Pharmacy Association, American Health Care Background: PMH model based on Ashville Project Financial forecasts based on Hickory Project; ROI $8.43 : $1 23

24 STRATEGIC COMMUNICATION Who to Talk to Depends on ACO structure ACOs: Highlights and Considerations for Pharmacists. APHA ISSUE BRIEF SERIES. STRATEGIC COMMUNICATION Sample ACO Structure: MSSP (multi-health system) 24

25 STRATEGIC COMMUNICATION Who to Talk to Leadership Physician-led ACOs Hospital-led Point of Contact Chief medical officer or chief operating office Chief medical officer or chief operating office Insurer-led Chief contracting office or provider relations director ACOs: Highlights and Considerations for Pharmacists. APHA ISSUE BRIEF SERIES. STRATEGIC COMMUNICATION What to say and How to say it Strategic communication mad lib Health Policy 101. AcademyHealth

26 STRATEGIC COMMUNICATION What to say and How to say it Strategic communication mad lib I want to talk to you about It s important because Let me give you an example That s why I am asking Health Policy 101. AcademyHealth PRACTICE CASE STUDY Mr. John Q. Pharmacist is the manager of Neighborhood Pharmacy USA; an independent pharmacy in a rural area of Pennsylvania. Mr. Pharmacist recently learned that the local health system has become a public/private ACO (contracted with the Medicare Shared Savings Program and Independence Blue Cross). Neighborhood Pharmacy USA has offered Medication Therapy Management successfully for several years. Mr. Pharmacist would like to approach the newly formed ACO to market his MTM services. 26

27 FINAL THOUGHTS ACOs policies and structure evolving Early pharmacy advocacy is critical APhA comments to CMS: March 2014 better integration of the Part D prescription benefit, especially MTM, into ACOs is necessary to achieve the goal of improved outcomes and efficiency Collaboration/Partnerships will be key: PPA, NACDS, NCPA, ASHP, Schools of Pharmacy, Legal, IT APhA Response to CMS Request for Information HELPFUL RESOURCES American Pharmacist Association ACO Issue Briefs Series MTM Central Center for Medicare & Medicaid Services Payment/sharedsavingsprogram/index.html?redirect=/share dsavingsprogram/ Institute for Healthcare Improvement Health Affairs 27

28 QUESTIONS? PLEASE PENNSYLVANIA PHARMACIST ASSOCIATION MID-YEAR CONFERENCE FEBRUARY 20, 2015 Christine M. O Leary, PharmD, BCPS REFERENCES 1. McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES. A national strategy to put accountable care into practice. Health Affairs May;29(5): IHI Triple Aim Initiative. The Institute for Healthcare Improvement. Available at: Accessed on January 17, Beis S. Accountable Care Organizations: Opportunities for Pharmacist. Proceedings of Ohio Society of Health-System Pharmacists Annual Meeting. April 10, Top 30 Accountable Care Organizations. SK&A Market Insight Report Cegedim Relationship Management. 5. Accountable Care Organizations 101. APhA ACO ISSUE BRIEF SERIES. American Pharmacist Association. Available at: Accessed on January 17, ACO Finance Models. APhA ACO ISSUE BRIEF SERIES. American Pharmacist Association. Available at: Accessed on January 17, Medicare Shared Savings Program. Center for Medicare & Medicaid Services. Available at: Payment/sharedsavingsprogram/index.html. Accessed on January 17, Accountable Care Organizations in Pennsylvania. Independent Pharmacy Alliance. Available at: Accessed on January 24,

29 REFERENCES 9. Barnett MJ, Frank J, Wehring H, et al. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm Jan-Feb;15(1): Amara S, Adamson R, Lew I, Slonim A. Accountable Care Organizations: Impact on Pharmacy. Hosp Pharm 2014; 49 (3): Trinity Pioneer ACO MTM Program. Iowa Pharmacy Association. Available at: Accessed on January 31, Wisconsin Pharmacy Quality Collaborative. Pharmacy Society of Wisconsin. Available at: Accessed on January 31, Pharmacist Caring for Diabetics: a pilot program in Missouri. National Community Pharmacy Association. Available at: Accessed January 31, ACOs: Highlights and Considerations for Pharmacists. APHA ISSUE BRIEF SERIES. American Pharmacist Association. Available at: Access on January 24, Strategic Communications Workshop. AcademyHealth. Health Policy 101 Annual Meeting. October Washington, DC. 16. Response to CMMI Request for Information. American Pharmacist Association. Submitted: March 1, Available at: Accessed on: January 24,

ACO Name and Location Allina Health Minneapolis, Minnesota

ACO Name and Location Allina Health Minneapolis, Minnesota ACO Name and Location Allina Health Minneapolis, Minnesota ACO Primary Contact Patrick Flesher Director, Payer Contracting & Pioneer ACO Program Email: Patrick.Flesher@allina.com Phone: 612-262-4865 Composition

More information

OUR ACO QUALITY RESULTS 2012 AND 2013

OUR ACO QUALITY RESULTS 2012 AND 2013 OUR ACO QUALITY RESULTS 2012 AND 2013 2012-2013 Patient and Caregiver Experience Source 2012 2013 ACO - 1 CAHPS: Getting Timely Care, Appointments and Information Survey 81.98 84.47 ACO - 2 CAHPS: How

More information

OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION

OBJECTIVES AGING POPULATION AGING POPULATION AGING IMPACT ON MEDICARE AGING POPULATION OBJECTIVES Kimberly S. Hodge, PhDc, MSN, RN, ACNS-BC, CCRN- K Director, ACO Care Management & Clinical Nurse Specialist Franciscan ACO, Inc. Central Indiana Region Indianapolis, IN By the end of this session

More information

Chapter Three Accountable Care Organizations

Chapter Three Accountable Care Organizations Chapter Three Accountable Care Organizations One of the most talked-about changes in health care delivery in recent decades is Accountable Care Organizations, or ACOs. Having gained the attention of both

More information

Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year

Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year Medicare Shared Savings Program Quality Measure Benchmarks for the 2014 Reporting Year Release Notes/Summary of Changes (February 2015): Issued correction of 2014 benchmarks for ACO-9 and ACO-10 quality

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Care for Medicare Patients: FACT SHEET Overview http://www.cms.gov/sharedsavingsprogram On October

More information

2013 ACO Quality Measures

2013 ACO Quality Measures ACO 1-7 Patient Satisfaction Survey Consumer Assessment of HealthCare Providers Survey (CAHPS) 1. Getting Timely Care, Appointments, Information 2. How well Your Providers Communicate 3. Patient Rating

More information

Steven E. Ramsland, Ed.D., Senior Associate, OPEN MINDS The 2015 OPEN MINDS Performance Management Institute February 13, 2015 10:15am 11:30am

Steven E. Ramsland, Ed.D., Senior Associate, OPEN MINDS The 2015 OPEN MINDS Performance Management Institute February 13, 2015 10:15am 11:30am Steven E. Ramsland, Ed.D., Senior Associate, OPEN MINDS The 2015 OPEN MINDS Performance Management Institute February 13, 2015 10:15am 11:30am The execution or accomplishment of work, acts, or feats The

More information

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)

ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What

More information

Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year

Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year Medicare Shared Savings Program Quality Measure Benchmarks for the 2015 Reporting Year Release Notes/Summary of Changes (February 2015): Issued correction of 2015 benchmarks for ACO-9 and ACO-10 quality

More information

Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Improving Quality of Medicare Patients: Overview The Centers for Medicare & Medicaid Services (), an agency within the Department

More information

ACO Public Reporting

ACO Public Reporting ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ 07960 (973) 971-7499 atlanticaco@atlantichealth.org www.atlanticaco.org

More information

ACO Public Reporting

ACO Public Reporting ACO Public Reporting ACO Name and Location AHS ACO LLC (Atlantic Accountable Care Organization) 465 South Street, Suite 205 Morristown, NJ 07960 (973) 971-7499 atlanticaco@atlantichealth.org www.atlanticaco.org

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

Effective ACO Compliance

Effective ACO Compliance Effective ACO Compliance HCCA Compliance Institute April 21, 2013 Margaret Hambleton, MBA, CHC, CHPC Sr. Vice President, Chief Compliance Officer St. Joseph Health System 1 Objectives Understand Accountable

More information

Mar. 31, 2011 (202) 690-6145. Improving Quality of Care for Medicare Patients: Accountable Care Organizations

Mar. 31, 2011 (202) 690-6145. Improving Quality of Care for Medicare Patients: Accountable Care Organizations DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services Room 352-G 200 Independence Avenue, SW Washington, DC 20201 Office of Media Affairs MEDICARE FACT SHEET FOR IMMEDIATE RELEASE

More information

Re: CMS-1345-P; Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations; Proposed Rule

Re: CMS-1345-P; Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations; Proposed Rule Department of Health and Human Services Attention: CMS 1345 P P.O. Box 8013, Baltimore, MD 21244 8013 Re: CMS-1345-P; Medicare Program; Medicare Shared Savings Program: Accountable Care Organizations;

More information

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015

What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015 What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures

More information

ACO s as Private Label Insurance Products

ACO s as Private Label Insurance Products ACO s as Private Label Insurance Products Creating Value for Plan Sponsors Continuing Education: November 19, 2013 Clarence Williams Vice President Client Strategy Accountable Care Solutions Today s discussion

More information

WHY THERE WILL BE CHANGE HEALTH CARE REFORM

WHY THERE WILL BE CHANGE HEALTH CARE REFORM Provider Partnerships: Surviving the Change Robert W. Markette, Jr. CHC Of Counsel Hall Render Killian Health & Lyman, P.C. One American Square, Suite 2000 Indianapolis, IN 46282 317-633-4884 Rmarkette@hallrender.com

More information

Assessing Value in Ontario Health Links. Part 1: Lessons from US Accountable Care

Assessing Value in Ontario Health Links. Part 1: Lessons from US Accountable Care Assessing Value in Ontario Health Links. Part 1: Lessons from US Accountable Care Organizations Applied Health Research Series Volume 4.1 Health System Performance Research Network Report Prepared by :

More information

Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012. CMS Measures. Primary Care Measures

Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012. CMS Measures. Primary Care Measures Primary Care in the U.S. Measuring and Improving Primary Care in the United States ISQua Indicators Summit 2012 Cliff Fullerton, MD, MS VP Chronic Disease Baylor Health Care System Number of PCPs in the

More information

Allscripts CQS Planning for 2014 Webinar: FAQs

Allscripts CQS Planning for 2014 Webinar: FAQs Allscripts CQS Planning for 2014 Webinar: FAQs Listed below are questions asked by attendees based on the CQS Planning for 2014 Webinars, held on May 8, May 28, and May 30, 2014. Answers are provided below.

More information

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN

INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS Karen Unholz, RN, BSN Origins of the Accountable Care Organization ACOs originated from the Patient Protection and Affordable Care Act (Healthcare Reform)

More information

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT. Norris Vivatrat, MD Associate Medical Director Monarch HealthCare

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT. Norris Vivatrat, MD Associate Medical Director Monarch HealthCare PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network

More information

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT

PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network

More information

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION

Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for

More information

Applying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team

Applying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team Applying ACO Principles to a Pediatric Population UH Rainbow Care Connection: Transforming Pediatric Ambulatory Care with a Physician Extension Team Ethan Chernin, MBA Director 1 Objectives Understand

More information

Welcome The AAMC, UHC and FPSC Web Conference on 2014 PQRS Proposed Changes will begin shortly.

Welcome The AAMC, UHC and FPSC Web Conference on 2014 PQRS Proposed Changes will begin shortly. Welcome The AAMC, UHC and FPSC Web Conference on 2014 PQRS Proposed Changes will begin shortly. Please do not place your phones on hold. If you need to leave the event, hang up and dial back into the conference.

More information

Addressing Barriers to Integration: Successful Reimbursement Strategies for Behavioral Health Providers in Primary Care

Addressing Barriers to Integration: Successful Reimbursement Strategies for Behavioral Health Providers in Primary Care Addressing Barriers to Integration: Successful Reimbursement Strategies for Behavioral Health Providers in Primary Care Colleen Clemency Cordes, Ph.D. Assistant Director Clinical Associate Professor Nicholas

More information

Quality Improvement and Payment Reform

Quality Improvement and Payment Reform Quality Improvement and Payment Reform Mark McClellan, MD, PhD Senior Fellow and Director, Initiative on Value and Innovation in Health Care Brookings Institution Mark McClellan. All rights reserved. No

More information

Advancing Accountable Care

Advancing Accountable Care Advancing Accountable Care Sean McBride Project Manager, Engelberg Center for Health Care Reform; Project Manager, ACO Learning Network Agenda 2. 4. Overview of national ACO Implementation: growing private

More information

ACO Program: Quality Reporting Requirements. Jennifer Faerberg Mary Wheatley April 28, 2011

ACO Program: Quality Reporting Requirements. Jennifer Faerberg Mary Wheatley April 28, 2011 ACO Program: Quality Reporting Requirements Jennifer Faerberg Mary Wheatley April 28, 2011 Agenda for Today s Call Overview Quality Reporting Requirements Benchmarks/Thresholds Scoring Model Scoring Methodology

More information

Coordinated care and comprehensive medication management: Case management s critical role

Coordinated care and comprehensive medication management: Case management s critical role Coordinated care and comprehensive medication management: Case management s critical role Terry McInnis, MD MPH President- Blue Thorn, Inc. Health Care Consulting Patrice Sminkey Chief Executive Officer

More information

Radiology Business Management Association Technology Task Force. Sample Request for Proposal

Radiology Business Management Association Technology Task Force. Sample Request for Proposal Technology Task Force Sample Request for Proposal This document has been created by the RBMA s Technology Task Force as a guideline for use by RBMA members working with potential suppliers of Electronic

More information

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights

Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of

More information

THE AFFORDABLE CARE ACT: KEY POINTS FOR PHARMACISTS. Sarah M. Smith, Pharm.D., BCACP Douglas H. Kay Symposium June 11, 2014

THE AFFORDABLE CARE ACT: KEY POINTS FOR PHARMACISTS. Sarah M. Smith, Pharm.D., BCACP Douglas H. Kay Symposium June 11, 2014 THE AFFORDABLE CARE ACT: KEY POINTS FOR PHARMACISTS Sarah M. Smith, Pharm.D., BCACP Douglas H. Kay Symposium June 11, 2014 Objectives 1. Summarize the major changes the Affordable Care Act (ACA) will have

More information

Accountable Care Organizations: What Are They and Why Should I Care?

Accountable Care Organizations: What Are They and Why Should I Care? Accountable Care Organizations: What Are They and Why Should I Care? Adrienne Green, MD Associate Chief Medical Officer, UCSF Medical Center Ami Parekh, MD, JD Med. Director, Health System Innovation,

More information

The Montefiore ACO and Behavioral Health Integration: A Work in Progress. Henry Chung, MD Bruce Schwartz, MD

The Montefiore ACO and Behavioral Health Integration: A Work in Progress. Henry Chung, MD Bruce Schwartz, MD The Montefiore ACO and Behavioral Health Integration: A Work in Progress Henry Chung, MD Bruce Schwartz, MD Agenda Describe the Montefiore Medical Center delivery system and experience in managing vulnerable

More information

DRAFT. To Whom It May Concern:

DRAFT. To Whom It May Concern: DRAFT Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1345-P, P.O. Box 8013, Baltimore, MD 21244-8013 To Whom It May Concern: As a nonprofit, nonpartisan

More information

2014 Medicare Physician Fee Schedule Proposed Rule Quality Provisions

2014 Medicare Physician Fee Schedule Proposed Rule Quality Provisions 2014 Medicare Physician Fee Schedule Proposed Rule Quality Provisions The 2014 Medicare Physician Fee Schedule (MPFS) Notice of Proposed Rulemaking (NPRM) was published in the Federal Register on July

More information

E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences

E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences Accountable Care Organizations and You E. Christopher Ellison, MD, F.A.C.S Senior Associate Vice President for Health Sciences CEO, OSU Faculty Group Practice Chair, Department of Surgery Ohio State University

More information

Accountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014

Accountable Care Communities 101. Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Accountable Care Communities 101 Jennifer M. Flynn, Esq. Senior Director, State Affairs Premier healthcare alliance January 30, 2014 Premier is the largest healthcare alliance in the U.S. Our Mission:

More information

Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations

Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Nuts and Bolts Accountable Care Organizations: A New Care Delivery Model for New Expectations Presented to The American College of Cardiology October 27, 2012 1 Franciscan Alliance Overview Franciscan

More information

9/17/2014. Accountable Care Organizations and Population Health Management. The Affordable Care Act

9/17/2014. Accountable Care Organizations and Population Health Management. The Affordable Care Act u Accountable Care Organizations and Population Health Management Tom Pianta, MPT Director, AAMC Collaborative Care Network The Affordable Care Act The ACA, CMS, the MD HSCRC and other payers are shifting

More information

Gold Coast Health IT Resource Center. Accountable Care Organization (ACO)

Gold Coast Health IT Resource Center. Accountable Care Organization (ACO) Gold Coast Health IT Resource Center Accountable Care Organization (ACO) August 27, 2013 Copyright 2013 Gold Coast HIT 1 Agenda Upcoming Webinars ACO s Copyright 2013 Gold Coast HIT 2 Upcoming Webinars

More information

- New Models: Community Pharmacy s Role in an ACO!

- New Models: Community Pharmacy s Role in an ACO! - New Models: Community Pharmacy s Role in an ACO! - Bruce Thompson, RPh, MS" - Director of Health System Pharmacy Services" - Hennepin County Medical Center" 1 Objectives q Realize the benefits Pharmacy

More information

Key Points about Star Ratings from the CMS 2016 Final Call Letter

Key Points about Star Ratings from the CMS 2016 Final Call Letter News from April 2015 Key Points about Star Ratings from the CMS 2016 Final Call Letter On April 6, 2015 CMS released the Announcement of Methodological Changes for Calendar Year 2016 for Medicare Advantage

More information

Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group

Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group Vermont ACO Shared Savings Program Quality Measures: Recommendations for Year 2 Measures from the VHCIP Quality and Performance Measures Work Group Presentation to VHCIP Steering Committee August 6, 2014

More information

MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D.

MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. MERCY-CR/UI HEALTH CARE ACCOUNTABLE CARE ORGANIZATION Dan Fick, M.D. Timothy Quinn, M.D. November, 2012 Accountable Care Organization An ACO is a group of health care providers who agree to take on a shared

More information

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations Pharmacy Practice Changes in ACA Accountable Care Organizations Avani S. Desai, PharmD & Emory S. Martin PharmD Sunday, April 12, 2014 9:05 10:05 am Pharmacist Learning Objectives At the conclusion of

More information

ACO Project Overview and Key Elements. Presented to FSSA September 3, 2013. 2013 Franciscan Alliance, Inc.

ACO Project Overview and Key Elements. Presented to FSSA September 3, 2013. 2013 Franciscan Alliance, Inc. ACO Project Overview and Key Elements Presented to FSSA September 3, 2013 2013 Franciscan Alliance, Inc. Background of Presentation House Enrolled Act 1328 requires the Indiana Family and Social Services

More information

Accountable Care Organizations: Notice of Proposed Rulemaking

Accountable Care Organizations: Notice of Proposed Rulemaking Accountable Care Organizations: Notice of Proposed Rulemaking Presentation by: Pam Silberman, JD, DrPH North Carolina Institute of Medicine April 15, 2011 1 Accountable Care Organizations (ACOs) An ACO

More information

Clinical Quality Reporting: Value Modifier

Clinical Quality Reporting: Value Modifier Clinical Quality Reporting: Value Modifier General Internal Medicine Grand Rounds August 13, 2013 Gail Albertson, MD Associate Professor of Medicine Chief Operating Office, University Physicians Future

More information

MEDICARE. Results from the First Two Years of the Pioneer Accountable Care Organization Model

MEDICARE. Results from the First Two Years of the Pioneer Accountable Care Organization Model United States Government Accountability Office Report to the Ranking Member, Committee on Ways and Means, House of Representatives April 2015 MEDICARE Results from the First Two Years of the Pioneer Accountable

More information

Accountable Care in 2014

Accountable Care in 2014 Accountable Care in 2014 Four Years Post ACA: How Will ACOs Evolve? Jane DuBose, Senior Director, Decision Resources Group Presentation to NAMCP, Fall 2014 1 Accountable Care Agenda ACO and value-based

More information

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis

Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Performance Measurement for the Medicare and Medicaid Eligible (MME) Population in Connecticut Survey Analysis Methodology: 8 respondents The measures are incorporated into one of four sections: Highly

More information

Accountable Care Organization 2013 Program Analysis

Accountable Care Organization 2013 Program Analysis December 21, 2012 Accountable Care Organization 2013 Program Analysis Quality Performance Standards Narrative Measure Specifications Prepared for Quality Measurement & Health Assessment Group Center for

More information

Comprehensive Primary Care (CPC) Assessment

Comprehensive Primary Care (CPC) Assessment Comprehensive Primary Care (CPC) Assessment Meaningful Use: The Building Block for CPC By Denise Anderson, Ph.D. NJ-HITEC February, 2013 The Centers for Medicare and Medicaid Services (CMS) jump-started

More information

ACOs: What They Are and How They Work? MedChi Facts 9/17/2014. MedChi Works to Enhance Health Care for All Marylanders

ACOs: What They Are and How They Work? MedChi Facts 9/17/2014. MedChi Works to Enhance Health Care for All Marylanders ACOs: What They Are and How They Work? Maryland MGMA Annual Conference Gene Ransom CEO, MedChi September 19, 2014 MedChi Facts MedChi is the seventh oldest medical society, formed in 1799 in Annapolis,

More information

Converting BIG Data into Value. Alan Krumholz MD, FAAP, DFACMQ

Converting BIG Data into Value. Alan Krumholz MD, FAAP, DFACMQ Converting BIG Data into Value Alan Krumholz MD, FAAP, DFACMQ Disclosure Statement I have no financial COI issues to disclose Neither myself nor Mayo Clinic endorse any of the sponsors of this meeting

More information

Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals. Objectives. National Organizations: Key Linkages

Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals. Objectives. National Organizations: Key Linkages Aligning Incentives for Quality: Pharmacy's Role in Achieving Hospital and National Goals Kasey K. Thompson, Pharm.D. Director, Practice Standards and Quality Division Director, Patient Safety American

More information

DATA ANALYTICS SOLUTION & MANAGED SERVICES

DATA ANALYTICS SOLUTION & MANAGED SERVICES DATA ANALYTICS SOLUTION & MANAGED SERVICES Who We Are is the premier provider of custom web solutions and cloud based products to the Healthcare industry. Value Proposition: We are a Florida based I.T.

More information

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases

Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic

More information

LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery

LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery LTC Division Webinar Accountable Care Organizations and LTC Pharmacy - The New Era in Health Care Delivery 1 The Pioneer ACO Model James Vasquenza Jr. Vice President, Preferred Provider Network, Innovatix

More information

Insight Into Evolving Payment and Delivery Models

Insight Into Evolving Payment and Delivery Models Insight Into Evolving Payment and Delivery Models Overview Objectives Provide an overview of Accountable Care Organization (ACO)-like payment and delivery models Demonstrate Genentech s commitment to patient

More information

CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations. June 26, 2014

CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations. June 26, 2014 CPR-PBGH Toolkit for Purchasers on Accountable Care Organizations June 26, 2014 Overview Introductions The Current ACO Landscape ACO Options Available to Employers Today Features of the Ideal ACO CPR-PBGH

More information

THE AMERICAN HEALTH CARE PARADOX

THE AMERICAN HEALTH CARE PARADOX THE AMERICAN HEALTH CARE PARADOX Friday, October 24 th Blue Cross Blue Shield Foundation of Massachusetts LAUREN A. TAYLOR, MPH Co-Author, The American Health Care Paradox Presidential Scholar, Harvard

More information

Health Care Environment

Health Care Environment Disclosures Anne L. Burns declares no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts,

More information

PCMH and Care Management: Where do we start?

PCMH and Care Management: Where do we start? PCMH and Care Management: Where do we start? Patricia Bohs, RN, BSN Quality Assurance Manager Kelly McCloughan QA Data Manager Wayne Memorial Community Health Centers Honesdale, PA Wayne Memorial Community

More information

Proven Innovations in Primary Care Practice

Proven Innovations in Primary Care Practice Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare

More information

PHOTO HERE. Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model

PHOTO HERE. Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model PHOTO HERE Monarch Pioneer ACO: Designing and Implementing a Successful Shared Risk Model March 2014 Agenda About Monarch HealthCare Monarch s Pioneer ACO Experience Monarch s Evolving ACO Strategy Future

More information

ACOs. ACO Definition. ACO Governance. Stuart B Black MD, FAAN Chief of Neurology Co-Director: Neurosciences Baylor University Medical Center at Dallas

ACOs. ACO Definition. ACO Governance. Stuart B Black MD, FAAN Chief of Neurology Co-Director: Neurosciences Baylor University Medical Center at Dallas Stuart B Black MD, FAAN Chief of Neurology Co-Director: Neurosciences Baylor University Medical Center at Dallas ACOs ACO Definition CMS definition of ACO Accountable Care Organizations (ACOs) are groups

More information

Advancing Accountable Care

Advancing Accountable Care Advancing Accountable Care April 19, 2012 S. Lawrence Kocot, JD, LLM, MPA Deputy Director, Engelberg Center for Health Care Reform; Senior Counsel, SNR Denton Sean McBride Project Manager, Engelberg Center

More information

Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures

Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures Vermont ACO Shared Savings Program: Recommendations for Year 2 Quality Measures Green Mountain Care Board October 9, 2014 10/9/2014 1 ACOs & SSPs Accountable Care Organizations (ACOs) are composed of and

More information

The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer

The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM Sue Thompson Chief Executive Officer 2 UnityPoint Health: Organizational Profile 3 4 UnityPoint Health Fort Dodge: Organizational

More information

Demonstrating Meaningful Use Stage 1 Requirements for Eligible Providers Using Certified EMR Technology

Demonstrating Meaningful Use Stage 1 Requirements for Eligible Providers Using Certified EMR Technology Demonstrating Meaningful Use Stage 1 Requirements for Eligible Providers Using Certified EMR Technology The chart below lists the measures (and specialty exclusions) that eligible providers must demonstrate

More information

Variations in Spending and Quality The Journey to Accountable Care

Variations in Spending and Quality The Journey to Accountable Care Variations in Spending and Quality The Journey to Accountable Care Elliott Fisher, MD, MPH Director, The Dartmouth Institute for Health Policy and Clinical Practice John E. Wennberg Distinguished Professor,

More information

Ohio s strategy to enroll primary care practices in the federal Comprehensive Primary Care Plus (CPC+) Program

Ohio s strategy to enroll primary care practices in the federal Comprehensive Primary Care Plus (CPC+) Program Ohio s strategy to enroll primary care practices in the federal Comprehensive Primary Care Plus (CPC+) Program Greg Moody, Director Governor s Office of Health Transformation Webinar for Primary Care Practices

More information

Converting BIG Data into Value. Alan Krumholz MD, FAAP, DFACMQ

Converting BIG Data into Value. Alan Krumholz MD, FAAP, DFACMQ Converting BIG Data into Value Alan Krumholz MD, FAAP, DFACMQ Disclosure Statement I have no financial COI issues to disclose Neither myself nor Mayo Clinic endorse any of the sponsors of this meeting

More information

Lessons Learned from a Pioneer ACO

Lessons Learned from a Pioneer ACO Lessons Learned from a Pioneer ACO Jim Farrell Senior Vice President, Marketing & Communications OSF HealthCare Tara Canty Senior Vice President Government Relations and COO, Accountable Care OSF HealthCare

More information

RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home

RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home Sergio Petrillo, PharmD Clinical Pharmacist Specialist, Rhode Island Hospital

More information

The Impact of Healthcare Reform on Pharmacy Practice. Disclosure

The Impact of Healthcare Reform on Pharmacy Practice. Disclosure The Impact of Healthcare Reform on Pharmacy Practice Thomas Buckley, MPH, RPh Assistant Clinical Professor University of Connecticut School of Pharmacy Disclosure Thomas Buckley has nothing to disclose

More information

Leveraging EHR Data Reporting Anita Christie, RN MHA CPHQ MA Department of Public Health

Leveraging EHR Data Reporting Anita Christie, RN MHA CPHQ MA Department of Public Health Improve Population Health Outcomes Leveraging EHR Data Reporting Anita Christie, RN MHA CPHQ MA Department of Public Health Massachusetts ehealth Institute MBI MASSACHUSETTS BROADBAND INSTITUTE MeHI MASSACHUSETTS

More information

Quality and Efficiency of Care Improved with Analytics and Workflow Redesign

Quality and Efficiency of Care Improved with Analytics and Workflow Redesign Quality and Efficiency of Care Improved with Analytics and Workflow Redesign London Health and Care Leaders Forum June 2, 2015 Simeon Schwartz, MD CEO, WESTMED Medical Group, P.C. WESTMED Medical Group

More information

Accountable Care Organization Workgroup Glossary

Accountable Care Organization Workgroup Glossary Accountable Care Organization Workgroup Glossary Accountable care organization (ACO) a group of coordinated health care providers that care for all or some of the health care needs of a defined population.

More information

Atrius Health ACO Initiative. Agenda

Atrius Health ACO Initiative. Agenda Atrius Health ACO Initiative November 9, 2012 Mark Yurkofsky MD Mark_yurkofsky@vmed.org 11/13/2012 1 Agenda Why the interest in the Pioneer ACO? What actually is Pioneer ACO anyway? What is Atrius Health?

More information

Henry J. Austin Health Center Kemi Alli, M.D. Chief Medical Officer kemi.alli@henryjaustin.org May 8, 2013

Henry J. Austin Health Center Kemi Alli, M.D. Chief Medical Officer kemi.alli@henryjaustin.org May 8, 2013 Henry J. Austin Health Center Kemi Alli, M.D. Chief Medical Officer kemi.alli@henryjaustin.org May 8, 2013 Henry J. Austin Health Center Presentation Outline 1. Henry J. Austin Health Center s Background

More information

Our Patient-Centered Medical Home a Process, not a Click

Our Patient-Centered Medical Home a Process, not a Click Our Patient-Centered Medical Home a Process, not a Click Richard Johnston, M.D. President, Medical Clinic of North Texas, P.A. Medical Clinic of North Texas, P.A. MCNT Physician Owned Primary Care Medical

More information

HEALTHCARE REFORM OCTOBER 2012

HEALTHCARE REFORM OCTOBER 2012 HEALTHCARE REFORM Tracking ACO Growth Nationally OCTOBER 2012 The enclosed slides are intended to provide you with a snapshot of how private sector accountable care organizations (ACOs) have formed since

More information

ACO Update: Trends, Results and the Future of Accountable Care

ACO Update: Trends, Results and the Future of Accountable Care ACO Update: Trends, Results and the Future of Accountable Care David Muhlestein, PhD Director of Research, Leavitt Partners September 16, 2014 Presentation Overview Basics of Accountable Care ACO Trends

More information

About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs.

About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. 1 Aaron McKethan PhD (amckethan@rxante.com) About NEHI: NEHI is a national health policy institute focused on enabling innovation to improve health care quality and lower health care costs. In partnership

More information

Population Health Management: Advancing Your Position in the Journey to Value-Based Care

Population Health Management: Advancing Your Position in the Journey to Value-Based Care Population Health Management: Advancing Your Position in the Journey to Value-Based Care Webcast Session One: An Integrated Approach to Population Health Management 11 August 2015 Welcome & Introductions

More information

Community Health Centers and Health Reform: Issues and Ideas for States

Community Health Centers and Health Reform: Issues and Ideas for States Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania

More information

ACOs: Six Things Specialty Practices Should Know

ACOs: Six Things Specialty Practices Should Know ACOs: Six Things Specialty Practices Should Know =TOS Newsletter, July/August 2014= Authors: John P. Schmitt, Ph.D. and J. Garrett Schmitt, MBA, PCMH CCE INTRODUCTION Do you remember the analogy of four

More information

Meaningful Use as the Foundation of the Medical Home

Meaningful Use as the Foundation of the Medical Home Meaningful Use as the Foundation of the Medical Home Thomas Novak Director of Delivery System Reform Health IT Use computerized provider order entry (CPOE) for medication, laboratory and radiology orders

More information

Population Health Solutions for Employers MEDIA RESOURCES

Population Health Solutions for Employers MEDIA RESOURCES Population Health Solutions for Employers MEDIA RESOURCES ABOUT MISSIONPOINT MissionPoint s mission is to make healthcare more affordable, accessible and improve the quality of care for our members. MissionPoint

More information

Pay for Performance: Its Influence on the Use of IT in Physician Organizations

Pay for Performance: Its Influence on the Use of IT in Physician Organizations Pay for Performance: Its Influence on the Use of IT in Physician Organizations Thomas R. Williams, M.B.A., M.P.H.,* Kristiana Raube, Ph.D., Cheryl L. Damberg, Ph.D., and Russell E. Mardon, Ph.D.** T he

More information

What to Expect in Next Year & Developing Your ACO Action Plan

What to Expect in Next Year & Developing Your ACO Action Plan What to Expect in Next Year & Developing Your ACO Action Plan Welcome The webinar will start at 3:00 pm ET. It is interactive, so please make sure that you have connected via phone with your audio pin.

More information