Becker's Hospital Review

Sign up for the COMPLIMENTARY Becker's Hospital Review CEO Report & CFO Report E-Weeklies at www.BeckersHospitalReview.com or call (800) 417-2035 21 100 Accountable Care Organizations to Know A significant number of accountable care organizations have formed since this publication's 2012 list of "80 Accountable Care Organizations to Know," and there were also some noteworthy developments from existing ACOs. Medicare ACOs proliferated within the past year. CMS named the original 32 Pioneer ACOs in December 2011 and the first 27 Medicare Shared Savings Program ACOs in April 2012. It added 87 more ACOs to the MSSP program in July 2012 for the program's second performance period, and 106 ACOs for the program's third performance period, which began Jan. 1, 2013. CMS expects to add another 100 to 200 ACOs within the next two years. It hasn't all been smooth sailing, however, as CMS experienced some contention with the 32 Pioneer ACOs in 2013. The Pioneers asked CMS to reconsider the quality metrics they are required to report on in 2013, urging CMS to hold them to reporting status only in 2013 instead of tying payments to performance. In April, CMS denied that request. Upon the release of first year performance data in July 2013, nine Pioneers announced their departure from the program. Seven will transition to the MSSP program, while two will drop out of CMS' ACO program completely. [Note: At the time of publication, only one of the two organizations dropping out entirely had identified itself. That organization is Presbyterian Health Services, based in Albuquerque, N.M.] On the commercial side, ACOs grew by leaps and bounds this year as well. There are approximately 8 to 14 million commercially insured patients in nonMedicare ACOs, according to MedeAnalytics, and ACO activity on the commercial side shows no sign of abating. In July 2013, the largest insurer in the country, UnitedHealth Group, unveiled plans to double its accountable care contracts over the next five years across employer-sponsored, Medicaid and Medicare plans. Cigna announced a similar goal in 2012, aiming to have one million members in ACO arrangements by 2014. 100 Accountable Care Organizations to Know By Heather Punke and Molly Gamble For our 2013 list, Becker's Hospital Review is pleased to highlight "100 Accountable Care Organizations to Know." This list includes Medicare and commercial ACOs, the majority of which are led by hospitals or health systems. ACOs were selected for inclusion based on the number of physicians involved and lives covered, as well as the lifespan of the ACO, whether it has multi-payer arrangements, and whether it recently struck new agreements with payers. ACOs are presented in alphabetical order and are listed by the formal name of the ACO or its affiliated health system or provider group. Abington (Pa.) Health. Abington Health is a twohospital system with two convenient outpatient facilities. The system signed an ACO contract with Independence Blue Cross and Lumeris, a healthcare technology firm, in February 2013. It is the first collaboration of its kind, with a health system, health insurer and a healthcare technology firm, in the Philadelphia area. The network includes about 200 physicians and 300,000 patients. Adventist Health-Portland (Ore.). Adventist HealthPortland is part of Roseville, Calif.-based Adventist Health. The system announced a collaborative care initiative with Regence BlueCross BlueShield of Oregon in May. That agreement includes a shared savings incentive for Adventist Health-Portland physicians. Advocare Walgreens Well Network (Marlton, N.J.). Advocare Walgreens Well Network is an ACO partnership between Walgreens and Advocare, a physician-owned multispecialty partnership with more than 100 offices in New Jersey and the greater Philadelphia area. It is one of three Medicare ACOs in the nation that involves Walgreens. Advocate Health Care (Oakbrook, Ill.). As an integrated health system, Advocate Health Care has been one of the trailblazers when it comes to accountable care. It launched its commercial ACO, AdvocateCare, with Blue Cross and Blue Shield of Illinois in October 2010. As of 2012, the ACO had 250,000 PPO and 125,000 HMO members. Advocate's physician group, Advocate Physician Partners, was accepted into the Medicare Shared Savings Program in 2012. The MSSP ACO covers more than 100,000 Medicare beneficiaries. Alexian Brothers Accountable Care Organization (Arlington Heights, Ill.). This ACO, anchored by four-hospital Alexian Brothers Health System, joined the Medicare Shared Savings Program in January 2013. Alexian Brothers ACO covers roughly 16,000 Medicare beneficiaries and is led by Don Franke, who serves as CEO. Allina Health (Minneapolis). Allina Health, a nonprofit 11-hospital system, is one of CMS' first 32 Pioneer ACOs. While the Pioneer ACO did not qualify to share in savings with Medicare after its first performance year, Allina's expense trend grew at less than 1 percent in 2012. In addition to its Pioneer ACO, Allina Health is part of the Northwest Metro Alliance, a collaboration between Allina and HealthPartners in Bloomington, Minn. The NMA is an ACO learning lab and covers more than 300,000 people. Arizona Connected Care (Tucson). Arizona Connected Care is Southern Arizona's first ACO, a limited liability company and joint venture between Tucson Medical Center and AzCC providers. CMS selected the organization to participate in the Medicare Shared Savings Program in April 2012. Arizona Connected Care also has accountable care contracts with Cigna and UnitedHealthcare.

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