A Pioneer ACO success story: Planning, infrastructure and compassion

by Stephen Rosenthal It is widely recognized in the healthcare field that a small percentage of complex patients drive the majority of expenses. This is true nationally as well as in the Bronx, New York, one of the nation's poorest and sickest counties, where Montefiore Medical Center is located. With more than 15 years of experience taking accountability for the health of patients through targeted, customized care, Montefiore was an accountable care organization before there were ACOs. We have spent years implementing and fine-tuning a system that addresses the complex and challenging needs of a population facing severe poverty, a high disease burden and lack of access to healthy foods and housing. Because of Montefiore's experience managing those challenges, the academic medical center was selected in 2011 as one of 32 Pioneer ACO models in the United States by the Centers for Medicare & Medicaid Services' Innovation Center. In the first year, Montefiore was able to achieve the triple aim of improved quality, patient outcomes and a significant lowering of costs. Montefiore also achieved the highest financial performance of all Pioneer ACOs, which equaled a 7 percent reduction in the cost of care or a savings of $23 million to Medicare. Based on those results, Montefiore received $14 million of the savings. So what made Montefiore's first-year efforts a success? We have found, and healthcare experts agree, the following attributes are needed: A strong prima...
Source: hospital impact - Category: Health Managers Authors: Source Type: blogs