2014 NC ACO Penetration (not including 2015 MSSP ACOs)

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Presentation transcript:

2014 NC ACO Penetration (not including 2015 MSSP ACOs)

2015 NC MSSP ACOS North Carolina has 18 Medicare Shared Savings Program ACOs Accountable Care Coalition of Caldwell County, LLC (2012) Accountable Care Coalition of Eastern NC (2012) Cape Fear Valley Health System (2015) Carolinas ACO, LLC (2014) CaroMont Health (2014) CHESS (Catawba Valley Medical Group, Inc., Cornerstone Health Care, P.A., High Point Regional Health System, Regional Physicians LLC, and Wake Forest University Health Sciences) (2015) Coastal Carolina Quality Care, Inc. (2012) Duke Connected Care (2014) Carolina Medical Home Network Accountable Care Organization, LLC (FQHCs) (2015) Mission Health Partners (2015) Physicians Healthcare Collaborative (Wilmington Health) (2013) Pinehurst Accountable Care Network (2015) Triad Health Network, LLC (2012) WakeMed Key Community Care (2014) Coastal Plains Network, LLC (Vidant) (2015) Bayview Physician Group (2014) Central Virginia Accountable Care Collaborative, LLC (2014) Pioneer Health Alliance (2015)

2015 NC ACOs with Commercial Contracts At least 10 ACOs have contracts with commercial payers (about 5 overlap with MSSP*) Accountable Care Alliance (Wilmington Health and NHRMC)-- BCBSNC* Boice Willis Clinic (Rocky Mount)--Cigna Cape Fear Valley Health System--BCBSNC* Carolina Advanced Health--BCBSNC Carolinas Health System--Aetna Cornerstone Health Care, PA--all commercial payers* Duke Connect Care--Cigna Key Physicians--Cigna* WakeMed Key Community Care--BCBSNC* Novant Health--Cigna

CMS Funding Opportunities Fall 2014 Transforming Clinical Practice Initiative (TCPI)— innovative model to support clinicians in achieving large-scale health care transformation; $840 million over 4 yrs/150,000 clinicians Provider Transformation Networks (PTN)—peer-based learning; 3 NC applicants: AHEC, CCNC, CHESS Support and Alignment Networks (SAN)—workforce development; 1 NC applicant: NCMS Foundation

CMS Funding Opportunities Fall 2014 ACO Investment Model (AIM)—upfront funding for MSSP ACOs serving rural and underserved populations NCMS Foundation Rural ACO Initiative Community Practitioner Program Participants Others RFP for services sent to select vendors

Recent Announcements Secretary Burwell announced that HHS would move: 30% of its total spending in Medicare to value-based payments by 2016; and 50% by 2018 through models like ACOs and bundled payments. The Health Care Transformation Task Force, a coalition of health care systems, payers and associations announced the formation of, a collaboration intended to bring to bear private-sector experience and influence in moving the market toward value-based care. move Move 75% of their revenue into value-based payments by 2020. Anthem, the third largest insurer in the US by membership, revealed that it had nearly $40 billion in value-based contracts and agreements with nearly 120 ACOs around the country. Anthem’s announcement is similar to earlier declarations from other insurers including United and Cigna. (Leavitt Partners)

Resources Toward Accountable Care Consortium and Initiative (TAC): www.tac-consortium.org National Association of ACOs (NAACOS): www.naacos.org CMS: Transforming Clinical Practice Initiative: http://innovation.cms.gov/initiatives/Transforming-Clinical- Practices/ ACO Investment Model: http://innovation.cms.gov/initiatives/ACO-Investment- Model/