Issue link: https://beckershealthcare.uberflip.com/i/717576
24 Cleveland Clinic. Cleveland Clinic CEO Toby Cosgrove, MD, told e Wall Street Journal in 2012 he didn't want to jump into an ACO too soon. Rather, he said the system wanted to wait until some of the learning was done and be "fast followers," not pioneers. Cleveland Clinic waited until 2015 to join the Medicare Shared Savings Program, aer testing the wa- ters in a 2013 collaborative care agreement with Cigna. Cleveland Clinic's MSSP ACO brings together the system's hospitals, employed physicians and several independent physicians as well. Cleveland Clinic chose to create a separate legal entity for its ACO to allow for more independent practices to join over time. Coastal Medical (Providence, R.I.). Coastal Medical, a physician-led medical group serving Massachusetts and Rhode Island, has participated in the Medicare Shared Savings Program since 2012. Coastal Medical's 2014 overall quality score of 94.58 percent put it among the top three MSSP ACOs for quality out of 333 organizations. Coastal Medical has also been successful in earning shared savings. In its first performance year of the MSSP, Coastal Medical earned nearly $3.6 million in shared savings, and in its second year brought in $3.3 million. It reinvested a portion of these savings into its services and transformation efforts, and then distributed the rest across all employees in the company, rather than only among its physician owners. Coastal Medical also has an ACO con- tract with UnitedHealthcare. Collaborative Health ACO (Natick, Mass.). Collaborative Health ACO embarked on its fourth year in the Medicare Shared Savings Program in January. It is in Track 3 of the program, which includes the most downside risk, but also has the most potential for reward. Collaborative Health ACO has two hospital participants — MetroWest Medical Center in Framingham, Mass., and Saint Vincent Hospital in Worcester, Mass. — as well as 45 physician practices. Cornerstone Health Enablement Strategic Solutions (High Point, N.C.). CHESS, a physician-led healthcare services company owned by Wake Forest Baptist Medical Center in Winston-Salem N.C., and Cor- nerstone Health Care in High Point, joined the Medicare Shared Savings Program in 2015. Aer just a year in the program, CHESS "graduated" to the Next Generation ACO program in January 2016. Additionally, this year CHESS coordinated ACO efforts with 140 physicians from Park Ridge Health in Hendersonville, N.C., and UnitedHealthcare. CHESS also works with the North Carolina Medical Society Foundation to help build ACOs in rural areas. Deaconess Care Integration (Evansville, Ind.). Deaconess Care Integra- tion got its start with Medicare ACOs in 2012 when it joined the Medi- care Shared Savings Program. e ACO included primary care physicians from across the six-hospital Deaconess Health System. Based on its suc- cesses in this program, it leveled up to the new Next Generation ACO model in January 2016. In coordinating this effort, Deaconess has opened its doors to other regional physicians to participate in this program as well as its OneCare Collaborative, a group of five regional hospitals and more than 160 primary care providers dedicated to value-based care. DeKalb PHO (Decatur, Ga.). e nonprofit DeKalb Physician Hospital Organization has seen a flurry of ACO activity so far this year. Most re- cently, DeKalb PHO entered into ACO contracts with commercial pay- ers UnitedHealthcare and Humana. It already operates a collaborative care initiative with Cigna that was announced in mid-October 2015. In partnership with White Plains, N.Y.-based Collaborative Health Sys- tems, DeKalb PHO renewed its participation this year in the Medicare Shared Savings Program. Under the name Accountable Care Coalition of DeKalb, it is one of the program's six Track 2 ACOs. Delaware Valley ACO (Villanova, Pa.). Delaware Valley ACO joined the Medicare Shared Savings Program in 2014, and in its first performance year saw significant success. Of 333 ACOs in the program, DVACO ranked among the top 10 for shared savings, with $6.57 million. It has an array of commercial ACOs in its portfolio, including contracts with Aetna, Humana and UnitedHealthcare. Dignity Health (San Francisco). Dignity Health was an early ACO adopter. It operated a pilot ACO program in 2009 with Blue Shield of California and San Ramon, Calif.-based Hill Physicians Medical Group for roughly 44,000 state employees. Aer reducing hospital readmissions by 22 percent and saving $20 million, the program was deemed a success and was expanded in 2011 to include UCSF Medical Center and cover San Francisco city and county employees. Kathleen Sebelius, then-secre- tary of HHS, called the effort "one of the best examples of patient care in the country," in 2011. e trio — Hill Physicians, Dignity and Blue Shield — launched another three-year ACO agreement in 2014 for an addition- al 14,600 HMO patients in San Joaquin County. Dignity also manages an ACO in collaboration with Dallas-based Tenet Healthcare that includes more than 3,400 providers, called the Arizona Care Network. Essentia Health (Duluth, Minn.). Essentia Health launched a Medicare Shared Savings Program ACO in July 2012, and within a year it became one of the first six ACOs in the nation to earn Level 2 ACO designation from the National Committee for Quality Assurance. By October 2013, it had achieved the highest level of accreditation, Level 3. When Essentia Health renewed its accreditation as a Level 3 ACO with the NCQA in March, it was just one of two U.S. health systems to have achieved this designation. Essentia Health is now enrolled in Track 3 of the shared savings program, the most advanced track. is fall, Essentia and Medica plan to roll out a new ACO in Minnesota, North Dakota and Wisconsin. Fairview Health Services (Minneapolis). Fairview joined the Pioneer program in 2012 and serves more than 13,000 Medicare patients through the program. Its ACO is comprised of an integrated delivery system and clinically integrated network that span roughly 275 providers and 46 clin- ics, both independent and Fairview-owned. ough the program sus- tained a loss in its second performance year, it is one of just nine Pioneer ACOs still standing. e system also has a partnership with North Me- morial Health Care in Robbinsdale, Minn., and Medica, forged in 2013 to create the Fairview and North Memorial Vantage with Medica ACO. Franciscan Alliance (Mishawaka, Ind.). Franciscan Alliance launched an ACO with Anthem Blue Cross and Blue Shield of Indiana in July 2014 that covered 60,000 patients. Within its first full year, the ACO generated nearly $22 million in cost savings and noted a 2 percentage-point increase in medication adherence for diabetes, cholesterol and hypertension; 7 percent improvement in pediatric wellness visits and a decrease in pre- ventable emergency room visits. Last January, Franciscan Alliance kicked off another ACO, this one in the Medicare Shared Savings Program. Genesis HealthCare ACO (Kennett Square, Pa.). Genesis HealthCare joined the Medicare Shared Savings Program in January and services nine states: Delaware, Kentucky, Maryland, Massachusetts, New Hamp- shire, New Jersey, Pennsylvania, Rhode Island and West Virginia. e ACO is affiliated with the national short-term post acute, rehabilitation, skilled nursing and long-term care services provider of the same name. is is the first MSSP ACO to be led by a post-acute care provider. Hackensack Meridian Health (Edison, N.J.). e result of the newly minted merger between Hackensack University Health Network and Meridian Health in New Jersey, Hackensack Meridian Health has an impressive combined portfolio of ACOs. Hackensack brings the Hack- ensack Alliance ACO, which was one of the first 27 organizations to join the Medicare Shared Savings Program in April 2012. It has generated more than $8 million in shared savings in its first two performance years. Meridian also brings an MSSP ACO, which has been in the program since 2013 and generated more than $7.2 million in shared savings in its first performance year. is year, Meridian launched a co-branded ACO with Aetna that includes Meridian's clinically integrated network, hos- pital-based physicians, affiliated providers and independent physicians.