Fierce Q&A: CEO of Mount Sinai ACO stresses local coordinated care


The accountable care organization (ACO) movement still is going strong, as the Centers for Medicare & Medicaid Services yesterday announced 89 new ACOs to the Medicare Shared Saving Program. That brings the number of providers participating in Medicare Shared Savings initiatives up to 154.

Mount Sinai Care in New York City--part of Mount Sinai Medical Center--is among these newest additions to the accountable care program. FierceHealthcare caught up with Mark Callahan (pictured), M.D., CEO of Mount Sinai Care and chief medical officer and associate dean for excellence in clinical care at the school of medicine, to talk about the new program, why the organization signed up for the Medicare Shared Savings Program and what the future holds for the accountable care delivery model.

FierceHealthcare: What was behind the Mount Sinai's decision to participate as a Medicare Shared Savings Program ACO?

Mark Callahan: We see that the payment landscape is going to evolve rapidly over the next couple years and view the Shared Savings plan as an entry point to start getting some of the skill sets around population management and cost-effective medicine that are going to be critical in the future.

FH: So far, what has been the biggest challenge to implementing the ACO model?

MC: It's brand new for us here because we just got accepted for the July 1 start date, but we have been doing a lot of work in the meantime. There are a lot of challenges around care patterns in New York City, in general--around data access and sharing--and there are difficulties around trying to implement standardized care guidelines across our group of providers.

Those are things we think we can solve, but they are real issues, of course.

FH: What are the goals of Mount Sinai's ACO? What kind of outcomes do you expect?

MC: We want to really provide high-quality care to our Medicare beneficiaries that is also cost-effective care. To achieve that, we view our goals as reducing unnecessary readmissions by managing chronic diseases better. When we do have an acute care episode, we want to make sure that we do it right and do it quickly so that we have as few complications and readmissions as possible. By doing these things, we'll be able to also hold down the cost of care.

FH: What other organizations are involved in Mount Sinai Care and how are they aligned?

MC: The main providers are Mount Sinai physicians and Mount Sinai Hospital. So all the physicians are members of the full-time staff here or practices that Mount Sinai owns through the School of Medicine. Then we're using Mount Sinai Hospital Manhattan and Mount Sinai Hospital Queens. That said, we also have practices that are owned by Mount Sinai out in places as far as Long Island, Queens and up into southern Westchester.  

We're also going to work very closely with partners like Visiting Nurse Service, who has been a long-time clinical partner here at Mount Sinai and is going to be very important to our success in managing patients who need some kind of after-care or long-term care program.