In an effort to better manage the health of populations served, achieve efficiencies in care delivery and improve overall experience and satisfaction of patients and their families, Broward Health has formed Broward Health ACO Services, Inc., an Accountable Care Organization (ACO).
As an ACO, Broward Health plans to participate in the Medicare Shared Savings Program (MSSP) beginning on January 1, 2015. In addition, we are further exploring and in dialogue with commercial health plans for shared savings and/or risk-based arrangements through the ACO.
We invite providers and organizations who currently serve or would like to serve patients in Broward Health’s community to join our hospitals as well as employed and community physicians in this ACO to broaden the network and improve access to care. Participating providers who meet quality and cost benchmarks may be eligible to receive incentive payments. There is no downside or financial risk associated with participation and no financial investment is required to join the ACO.
Providers who would like to join Broward Health’s ACO should contact Lori Perlman, Vice President of Managed Care for Broward Health, at 954-847-4521 or firstname.lastname@example.org to discuss this opportunity in greater detail.
Below are some key questions and answers about the program and provider participation.
Frequently Asked Questions
What is the Medicare Shared Savings Program (MSSP)?
The Patient Protection and Affordable Care Act (ACA) of 2010 required the Centers for Medicare & Medicaid Services (CMS) to establish a shared savings program to facilitate care coordination among providers to improve the quality of care and reduce unnecessary costs for Medicare Fee-for-Service (FFS) beneficiaries. The program is designed to improve outcomes for Medicare FFS beneficiaries and increase the value of care by:
- Promoting accountability for the care of Medicare FFS beneficiaries
- Requiring coordinated care for all services provided under Medicare FFS
- Encouraging investment in infrastructure and redesigned care processes
Providers and hospitals may participate in the program by creating or participating in an Accountable Care Organization (ACO).
What is an Accountable Care Organization?
An Accountable Care Organization (ACO) is a collection of healthcare providers and care management professionals working together to manage and coordinate care for a defined population. An ACO’s goal is to reduce overall costs and improve quality and outcomes. If the ACO is successful, participating providers may be eligible to receive a percentage of shared savings or bonus payments based on savings benchmarks and quality measures. In the Medicare Shared Savings Program, an ACO must serve at least 5,000 Medicare FFS beneficiaries. The ACO Board of Directors will work with ACO providers and committees to establish criteria for shared savings. Providers will need to satisfy minimum criteria, likely quality and cost benchmarks, to qualify for Shared savings.
What does it mean to become an ACO Provider?
If you choose to participate in Broward Health’s ACO, you will be asked to actively coordinate and manage the care of Medicare FFS beneficiaries attributed to the ACO Provider as well as other patients through commercial arrangements. Broward Health will support you in doing this through the identification of beneficiaries, provision and analysis of beneficiary claims data, as well as providing you with evidence-based guidelines and care management workflows to address the most prevalent diagnoses and/or highest risk patients among the population (e.g., heart disease, hypertension).
What does this mean for my patients?
As ACO beneficiaries, patients will receive better coordinated, collaborative care. They remain free to obtain medical care from providers they choose. All patients will be notified about the ACO and will also have the opportunity to opt out of sharing their claims data.
Who is leading the ACO?
The ACO will be overseen by a Board of Directors that includes members from Broward Health Board of Commissioners as well as one community physician and one Medicare fee-for-service (FFS) beneficiary served by the ACO. The ACO will also establish committees to oversee and provide input on quality, care coordination, evidence-based guidelines, and beneficiary engagement. Community physicians will be invited to participate on or even co-chair these committees.
Am I at risk if the ACO experiences losses?
No. The ACO will only participate in shared savings for the first three years of the program; the ACO will not participate in shared losses with CMS. At the end of the ACO’s three year contract with CMS it will have the opportunity to extend its contract and participate in both shared savings and shared losses or terminate the agreement. At that time, ACO providers will have the opportunity to terminate their participation in the ACO or renew their agreement with the ACO.
How do I sign up to participate in the ACO?
Providers who would like to join the ACO must review and sign the ACO Participation Agreement. Contact Lori Perlman, Vice President, Managed Care for Broward Health, at 954-847-4521 or email@example.com to discuss this opportunity in greater detail.
We hope you will join us as we work together to improve the quality of the healthcare and promote wellness in our community.