Accountable Care Organizations
‘Leaning in to change’ to benefit patients
Coordinating patient care can be challenging. Different medical offices may use different record-keeping systems. Changing physicians may mean each office holds partial – and sometimes contrary – accounts of someone’s health history. If records aren’t up-to-date, one doctor may think a patient is taking a medication the patient no longer takes. And in the doctor’s office, patients spend time recreating medical histories, rather than focusing on the reason for their visit. What’s more, sorting through this confusion can add to costs.
Bringing better coordination to patient care is the idea behind Accountable Care Organizations, known as ACOs. Groups of physicians, hospitals, and payers share patient data, which can improve care, reduce hospital readmissions, and provide savings for patients, providers, and payers.
UT Southwestern was an early participant in ACOs, creating the UT Southwestern Accountable Care Network (UTSACN) in 2013. The ACO was among less than 20 percent of such organizations nationwide to save money within its first year of operation. ACOs share with Medicare any savings generated from lowering health care costs when they meet standards for high-quality care. The UT Southwestern ACO’s outstanding first-year performance in 2014 enabled it to achieve $6 million in savings for Medicare, of which UT Southwestern’s share of $2.9 million will be used to support the activities of UTSACN. This performance was part of $411 million in net savings achieved by ACOs nationally in 2014 – about $40 million more than the prior year.
Although cost savings are important, enhancing patient safety, efficiency and quality are compelling reasons ACOs are flourishing. ACOs are held to high quality standards, ensuring that savings are achieved through improved care coordination and care that is appropriate, safe, and timely. The Centers for Medicare and Medicaid Services (CMS) – the part of the U.S. Department of Health and Human Services that oversees ACOs – evaluates the organizations on 33 quality measures relating to patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations.
For patients, information sharing among ACO participants can mean less duplication, with fewer medical forms asking for the same information and fewer medical tests that must be repeated. For health care providers, information sharing means greater familiarity with the patient’s health care history, needs, and preferences.
“We are very proud of our initial successes in achieving a reduction in the cost of care while delivering high-quality care and outcomes,’’ said UT Southwestern President Dr. Daniel K. Podolsky. “ACOs are an idea whose time has come … and ultimately patients, health care providers, and the general public all benefit.”
Success Spurs Expansion
UT Southwestern’s early success with ACOs has led to expansion.
In January 2015, Texas Health Physicians Group (THPG) partnered with UT Southwestern faculty members and UT Southwestern’s Clinically Affiliated Physicians group (UTSCAP) to participate in the Medicare Shared Savings Program (MSSP). With more than 67,000 patients, this is among the largest MMSP programs in the United States.
“Accountable Care Organizations represent the future of medicine in this country, so it’s appropriate that North Texas’ leading ACO would be affiliated with UT Southwestern, which is known for delivering the future of medicine today,” said Dr. Mack Mitchell, Professor and Vice Chair of Internal Medicine, who serves as Chief Medical Officer for the UT Southwestern Accountable Care Network (UTSACN).
He added, “UT Southwestern is proud to have our clinicians participating in closely knit, community-based care teams that are measurably improving the health of our patients and the community and reducing costs for patients.”
In addition, UT Southwestern has joined four other leading health care systems in North Texas – Children’s Health System of Texas, Cook Children’s, Methodist Health System, and Texas Health Resources – in the launch of Forward Health Partners. The Forward Health Partners ACO will encompass 42 hospitals, 72 outpatient facilities, more than 1,300 primary care physicians, and more than 4,100 specialists to provide service to members of participating health plans and self-insured employers in the Dallas-Fort Worth region.
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Dr. Podolsky holds the Philip O’Bryan Montgomery, Jr., M.D. Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science.
