On January 10, Health and Human Services (HHS) Secretary Kathleen Sebelius announced that UCLA Health System had been approved as one of 106 new Accountable Care Organizations (ACOs) in Medicare. UCLA is one of the few existing health systems in California to get approved, and one of the only academic medical centers to be approved for high-quality Medicare services. The approval ensures that as many as 4 million Medicare beneficiaries across the US now have access to high-quality, coordinated care, today.
Since passage of the Affordable Care Act, more than 250 Accountable Care Organizations have been established. Beneficiaries using ACOs always have the freedom to choose doctors inside or outside of the ACO. Accountable Care Organizations share with Medicare any savings generated from lowering the growth in healthcare costs, while meeting standards for quality of care. “Accountable Care Organizations save money for Medicare and deliver higher-quality care to people with Medicare,” noted Secretary Sebelius. She added, “Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve.”
ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care. Federal savings from this initiative are up to $940 million over four years. The new ACOs include a diverse cross-section of physician practices across the nation. Approximately half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20% of ACOs include community health centers, rural health centers, and critical access hospitals that serve low-income and rural communities.
The approved medical facilities also include 15 Advance Payment Model ACOs, which are physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination. Medicare expects to recapture advance payments over time through future shared savings. In addition to these ACOs, in 2012 CMS launched the Pioneer ACO program for large provider groups able to take greater financial responsibility for the costs and care of their patients over time. In total, Medicare’s ACO partners will serve more than 4 million beneficiaries nationwide.
In the January 10 announcement, HHS issued a new report showing Affordable Care Act provisions are already having a substantial effect on reducing the growth rate of Medicare spending. Growth in Medicare spending per beneficiary hit historic lows during the 2010 to 2012 period, according to the report. Projections by both the Office of the Actuary at CMS and by the Congressional Budget Office estimate that Medicare spending per beneficiary will grow at approximately the rate of growth of the economy for the next decade, breaking a decades-old pattern of spending growth outstripping economic growth.
"Through participation in the Medicare Shared Savings Program and other initiatives, UCLA is taking an innovative approach to health care, focusing on high-value, high-quality care that is truly patient-centered," said Dr. Molly Coye, chief innovation officer for the UCLA Health System. "UCLA aims to be a leader in transforming health care and reigning in uncontrolled health care costs."
"UCLA Health System has truly outstanding, high-quality, evidence-based medical programs, and the Medicare Shared Savings Program provides us with an important framework to better coordinate care for our Medicare patients," said Dr. David Feinberg, president of the UCLA Health System, CEO of the UCLA Hospital System, and associate vice chancellor for health sciences at UCLA.
"UCLA Health System is one of only a few academic medical centers to participate in this program," said Dr. Samuel A. Skootsky, chief medical officer of the UCLA Faculty Practice and Medical Group. "UCLA Health System has a strong foundation in primary care, including a 'medical home' initiative to improve care coordination for our patients, in addition to exemplary specialty care. This Medicare Shared Savings Plan challenges hospitals and doctors, together with their patients, to reevaluate and redesign patient care to be more patient-centered and efficient — across all care settings, including at home."
"Our primary care network is recognized as one of the best in the state of California, and our system-wide patient satisfaction ratings are in the 99th percentile in the nation," said Dr. Patricia Kapur, CEO of the UCLA Faculty Practice Group. "The framework we currently have in place provides us with a perfect opportunity to work with the federal government's Shared Savings Program to transform the delivery of excellent medical care."