Partners HealthCare has been selected by the Commonwealth of Massachusetts as one of six organizations to participate in the MassHealth Accountable Care Organization (ACO) Pilot program. The MassHealth ACO Pilot program, set to launch December 1st, is part of the state’s biggest restructuring of the Medicaid program in over twenty years. Similar to federal ACO programs, the MassHealth ACO program aims to move from existing fee-for-service models where providers are paid for each service to an accountable care model where care is better coordinated and physicians are rewarded for providing high quality care while keeping costs under a target.
As part of this Pilot, Partners will implement a flexible model of care for MassHealth members, called Partners Care Connect, that is tailored to their individual needs and supported by new and existing population health programs across the Partners network. These services include team-based care delivery, care management for high risk patients, as well as behavioral health programs integrated with primary care in both the hospital and community settings so patients can more easily access treatment. To meet the needs of MassHealth members, these services will be expanded to address substance use disorders, housing, food insecurity, trauma history, and other social determinants of health. Partners Care Connect will meet patients where they are and work with them to identify a care plan that addresses all of their health-related needs, including building strong relationships between patients and providers.
Participating in the Medicaid ACO Pilot is an exciting opportunity to think more broadly about how we can improve the health of the populations we serve. Success for our patients will be achieved not only by delivering better care in the office or hospital, but also by bringing healthcare into the home. We will partner in new ways with community organizations, local service providers, and city/state initiatives.Eric Weil, MD Chief Medical Officer of Partners' pilot
“Participating in the Medicaid ACO Pilot is an exciting opportunity to think more broadly about how we can improve the health of the populations we serve,” said Eric Weil, MD, Chief Medical Officer of Partners’ pilot. “Success for our patients will be achieved not only by delivering better care in the office or hospital, but also by bringing healthcare into the home. We will partner in new ways with community organizations, local service providers, and city/state initiatives.”
The MassHealth ACO Pilot represents the first year of MassHealth’s planned six year accountable care program. The state’s Medicaid population consists of approximately 1.9 million low-income people (28% of the state’s population) and accounts for 40% of the state’s budget. MassHealth spending is growing at a substantial rate annually and is outpacing revenue growth for the Commonwealth. A new waiver (1115) was negotiated with the federal government to support this new model of care, which includes $1.8 billion in investments in delivery system reform, including MassHealth’s ACO models, increased funding for behavioral health and long-term care services, and a focus on social services not traditionally reimbursed as part of medical care.
The ACO model is not new to Partners. In 2012, Partners was selected by the federal government to pilot one of the first ACO programs in the country, called the Pioneer ACO. Over the past four years, Partners has achieved nearly $31 million in cost savings and has been recognized as one of the best ACOs in the nation for delivering high quality care with an overall quality score of 96.04%.
This MassHealth ACO Pilot reinforces the decades long commitment of clinicians and administrators at Massachusetts General Hospital, Brigham and Women’s Hospital, Newton-Wellesley Hospital, and North Shore Medical Center who serve underserved populations in Mission Hill, Roxbury, Jamaica Plain, Dorchester, Charlestown, Chelsea, Revere, Everett, Lynn, and Salem, among others.
“We are excited to deepen our community partnerships and collaborate with the full range of care delivery service providers required to maximize the health of this frequently underserved population. The Medicaid ACO Pilot is another important step forward toward our goal of delivering the nation’s best healthcare to the people of Massachusetts, and we commend the leadership at the Executive Office of Health and Human Services and MassHealth for their diligent efforts to address the numerous challenges that inevitably come with such big changes, ” said Tim Ferris, MD, Senior Vice President of Population Health Management at Partners HealthCare.
The MassHealth ACO Pilot will launch December 1st 2016 and run until December 2017. For more information on Partners' efforts click here.