With the launch of the first Pioneer accountable care organizations (ACO), effective Jan. 1, patients now are receiving word about changes to their providers--but often, with little understanding of what an ACO even is, The Boston Globe reports.
For example, Partners HealthCare, which includes Massachusetts General and Brigham and Women's hospitals, has begun fielding calls from senior patients about recent letters they received about the changes, including their choice to opt out.
The Centers for Medicare & Medicaid Services (CMS) last month approved 32 Pioneer ACOs made up of healthcare systems, hospitals, physician groups and payers, effectively launching a new Medicare payment model that rewards collaboration for much-touted "the right care, in the right place, at the right time." CMS will use 33 quality measures as a basis for performance and therefore payment.
Providers under the Pioneer ACO model also are stressing to patients that unlike the managed care model of the 1990s, patients can choose where they are treated because the ACOs will not restrict which physicians or hospitals patients can visit.
Patients also will have greater access to care and likely see new care provider faces. With a focus on keeping patients out of the hospital, organizations are adding nurses and social workers, as well as software to track hospital discharges, to follow up with patients on tests and to check on medication refills, according to The Denver Post.
For example, Physician Health Partners, a physician group in Colorado, is spending money upfront to save the system money later and improve patient health, according to Dr. Alan Lazaroff, a Denver geriatrician who works with Physician Health Partners.
"More care is not better; less care is not better. Only better care is better," he said in the Denver Post article.
The government anticipates that Pioneer ACOs will save Medicare $1.1 billion over five years.
For more information:
- read the Boston Globe article
- here's the Denver Post article
Pioneer ACOs to ring in the new year
CMS selects 32 final Pioneer ACOs
CMS poised to select first Pioneer ACOs
Choose ACO consultants with caution
'Commonplace' ACO accreditation could raise costs