Indiana Life Sciences Collaboration Conference Series

Transcription

1 Indiana Life Sciences Collaboration Conference Series Integrated Healthcare? ACOs and Their Impact May 11, 2012 Why Pioneer with Medicare ACO? Presented by: By Jay R. Brehm, Exec. V.P./Regional CFO Franciscan St. Francis Health

2 The Top 10 Reasons to Participate in the Pioneer ACO 10. Flexibility in ACO program design 9. Participation in shared learning activities with other Pioneer ACOs 8. Allows providers to participate as they become ready, reducing risk 7. Encourages EPIC EMR optimization 6. Focus on quality initiatives & reportable, transparent outcomes 5. Link independent primary care physicians with the Franciscan system 4. Attractive to commercial payers for future payment innovation programs 3. Increased market share opportunity via the development of new relationships with other providers & provider organizations 2. Core competency development: chronic disease management And the number 1 reason. PUTS A GREATER FOCUS ON PATIENT-CENTERED CARE! 2

3 Franciscan Alliance & Accountable Care Organization Why? It is Our Mission. When the Sisters of St Francis of Perpetual Adoration Came to America their mission was, as it is today To provide health care to the poor and the sick especially the elderly, children and the disenfranchised. 3

4 Accountable What? What is accountable care? Accountable care is care that manages patients along the entire care continuum, from preventive health through end-of-life. What are Accountable Care Organizations (ACOs)? ACOs are networks of providers and suppliers of services that agree to be jointly accountable for managing the health of patient populations across different providers and provider settings (i.e. the care continuum). ACOs work together to coordinate care for the patients they serve. What are some characteristics of ACOs that help achieve the Triple Aim? ACOs deliver coordinated, high quality care to beneficiaries. ACOs are patient-centered organizations: patients and providers are true partners in care decisions. Data & information-sharing are central: providers can access historical patient care information from multiple care providers to avoid unnecessary care. 4

5 What is Accountable Care? Someone is taking ownership and being responsible for your care through all phases of your healthcare. 5

6 What are Accountable Care Organizations (ACOs)? ACO s are patient-centered, where patients, providers and payors become partners ACOs work together to coordinate care for the patients they serve Care Management Intensive outpatient management IT Two-way data flow/collection; tele-health; e-communication 6

7 Who is Part of the Accountable Care Organization? Franciscan Alliance, St Francis Health Indianapolis Mooresville Carmel Major Hospital Shelbyville Rush County Memorial Fairbanks Kindred Windrose Health Centers Indiana Internal Medicine Associates St Francis Medical Group 7

8 If my doctor s in an ACO, can I still see whatever doctor I want? Absolutely if your doctor participates in an ACO, you can see any healthcare provider who accepts Medicare. Nobody not your doctor, not your hospital can tell you who you have to see. 8

9 Is an ACO a Health Maintenance Organization (HMO), managed care or an insurance company? No. An ACO is a group health care providers who work together to provide you with better, more coordinated care. An ACO can t tell you which health care providers to see and can t change your Medicare benefits. If your doctor participates in a Medicare ACO, you always have the right to choose any doctor or hospital who accepts Medicare at any time. The providers in an ACO communicate with you and with each other to make sure that you get the care you need when you are sick, and the support you need to stay healthy and well. 9

10 Here are things that won t change because your doctor is part of an ACO: Your right to choose any hospital or doctor that accepts Medicare will not change even if that hospital or doctor is not part of an ACO What you pay, your Medicare benefits, or the cost of your coverage will not increase because your doctor is in an ACO 10

11 Some ACO s, like Franciscan Alliance ACO, may hire people to help check on your care They may call you after an appointment or a procedure to make sure you understand how to take your medicines or schedule follow-up visits. They will also share information with your doctor to make sure you get the right care 11

12 Franciscan Alliance Accountable Care Organization Thank you. 12