Beth Israel Deaconess Physician Organization - CMS Pioneer ACO
Reported Outcomes
Description:
Beth Israel Deaconess Physician Organization (BIDPO), which has more than 1,600 providers and is the physician organization affiliated with Beth Israel Deaconess Medical Center, was selected based in part on its experience in working with global payment models. The Pioneer ACO Model is designed to encourage the development of groups of doctors and other healthcare providers who work together to provide high quality care. Under the CMS Pioneer ACO program, BIDPO patients who are enrolled in Medicare continue to receive the excellent care from doctors they know and trust and in offices and hospitals where they are comfortable.
As one in a diverse group of leading-edge health care organizations from around the country, BIDPO was chosen specifically by the Innovation Center to test the effectiveness of several models of payment in helping organizations make a rapid transition to higher quality care at a lower cost to Medicare. Under the Pioneer ACO Model, CMS provides incentives for participating health care providers who form an organization to coordinate care for patients. Providers who band together through this model are required to meet quality standards based upon, among other measures, patient outcomes and care coordination among the provider team. CMS uses robust quality measures and other criteria to reward ACOs for providing beneficiaries with a positive patient experience and better health outcomes, while also rewarding BIDPO for reducing growth in Medicare expenditures for the same patient population.
Payment Model:
The payment models being tested in the first two years of the Pioneer ACO Model are a shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than levels currently proposed in the Medicare Shared Savings Program. In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model. These models of payments will also be flexible to accommodate the specific organizational and market conditions in which Pioneer ACOs work.
Cost Savings:
In the 1st year of operation, the Pioneer ACO:
- saved 4.2 percent of its budget for patient care, generating substantial savings for the federal Medicare health care program
- generated a return of $7.79 million for BIDCO
Data Source(s):
