80 Accountable Care Organizations to Know
Accountable care organizations have proliferated in the past three years. The increase has been spurred by private payors' interest in coordinated care management and the Patient Protection and Affordable Care Act, which introduced the Medicare Shared Savings Program. There has been a significant amount of ACO development within the past year specifically, as CMS revealed the first 32 Pioneer ACOs and, more recently, the first 27 Medicare ACOs. Commercial health insurers are also revealing extensive plans for ACO development. Major payors like Cigna, UnitedHealth Group, Blue Cross Blue Shield and Aetna continue to pursue performance-based contracts with providers across the country.
The following list includes 80 commercial and Medicare ACOs. They are presented alphabetically, either by the ACO's formal name or the name of the ACO's main provider.
Accountable Care Coalition of Caldwell County (Lenoir, N.C.). The ACC of Caldwell County was named by CMS as one of the first 27 participants in the Medicare Shared Savings Program. It is comprised of a partnership between Caldwell Memorial Hospital and Collaborative Health Systems. Of the 27 Medicare ACOs announced in April, nine of them are working with Collaborative Health Systems, which is a subsidiary of Medicare Advantage. The hospital, which opened in 1951, includes more than 50 providers. The ACO will serve more than 5,000 Medicare beneficiaries.
Accountable Care Coalition of Coastal Georgia (Savannah). Named in April as one of the first 27 ACOs within the Medicare Shared Savings Program, the ACC of Coastal Georgia consists of South Coast Medical Group and Collaborative Health Systems. Approximately 8,000 Medicare beneficiaries are covered by this ACO.
Accountable Care Coalition of Eastern North Carolina (New Bern). The Atlantic Integrated Health Network partnered with Collaborative Health Systems to form the ACC of Eastern North Carolina, which is participating in the Medicare Shared Savings Program. Atlantic Integrated Health Network includes more than 6,400 providers, and, founded in 1994, it is one of the oldest physician-led networks in the state. The ACO will serve about 10,000 Medicare beneficiaries.
Accountable Care Coalition of Greater Athens Georgia. The Coalition of Athens Area Physicians partnered with Collaborative Health Systems to form the ACC of Greater Athens Georgia, which is participating in the Medicare Shared Savings Program. The Coalition was founded in 1994 and includes more than 230 independent physicians. Approximately 8,500 Medicare beneficiaries are covered by this ACO.
Accountable Care Coalition of Mount Kisco (N.Y.). A participant in the Medicare Shared Savings Program, the ACC of Mount Kisco consists of a partnership between Mount Kisco Medical Group and Collaborative Health Systems. The medical group, founded in 1946, includes more than 270 physicians in 40 medical specialties at 25 locations.
Accountable Care Coalition of the Mississippi Gulf Coast. Formed by a partnership between Mississippi Coast Physicians and Collaborative Health Systems, the ACC of the Mississippi Gulf Coast is expected to serve about 7,000 Medicare beneficiaries. It is participating in the Medicare Shared Savings Program.
Accountable Care Coalition of the North Country (Canton, N.Y.). The ACC of the North Country is an ACO formed between North Country Physicians Organization and Collaborative Health Systems. North Country PO is a multi-specialty medical group that includes more than 170 physicians in 30 medical specialties. The ACO, which was recently selected by CMS to participate in the Medicare Shared Savings Program, is expected to serve about 5,300 beneficiaries.
Accountable Care Coalition of Southeast Wisconsin (Milwaukee). This ACO is comprised of a partnership between Independent Physician Network and Collaborative Health Networks. Established in 1984, IPN includes more than 900 affiliated physicians who care for more than 130,000 patients in southeastern Wisconsin. CMS recently named the ACO as one of the first 27 participants in the Medicare Shared Savings Program, and it is expected to cover about 10,000 beneficiaries.
Accountable Care Coalition of Texas (Houston). The ACC of Texas is comprised of independent physician associations, medical groups and health systems in the Houston and Beaumont areas of Texas, along with Collaborative Health Systems. The ACO is participating in the Medicare Shared Savings Program and is expected to serve approximately 70,000 beneficiaries.
Advocate Health Care (Oakbrook, Ill.). Advocate — a 10-hospital system — partnered with Blue Cross and Blue Shield of Illinois in October 2010 to form a three-year ACO called AdvocateCare. Advocate agreed to limit annual increases in return for the opportunity to share in savings resulting from clinical integration programs. BCBS of Illinois is the largest health insurer in the state, with nearly 7 million members. AdvocateCare most recently included approximately 375,000 members.
Allina Hospitals & Clinics (Minneapolis). Allina Hospitals & Clinics was selected as one of the first 32 ACOs to participate in CMS' Pioneer ACO program. The non-profit, 11-hospital system provides care for nearly a third of the population in Minnesota and western Wisconsin, and approximately 15,000 Medicare patients are covered by its ACO.
AppleCare Medical ACO (Artesia, Calif.). AppleCare Medical ACO is affiliated with AppleCare Group and includes partnerships with more than 800 physicians in the region, as well as major hospitals across Southern California. The ACO, which was selected to participate in the Medicare Shared Savings Program, is expected to serve nearly 8,000 people in Southern Los Angeles and Orange County.
Arizona Connected Care (Tucson). Arizona Connected Care is a collaboration of independent healthcare providers in Southern Arizona, including Tucson Medical Center, three federally qualified health centers and more than 150 physicians. The ACO will focus on care transitions and access to team-based primary care services. A participant in the Medicare Shared Savings Program, ACC is expected to cover about 7,500 beneficiaries.
AtlantiCare (Egg Harbor Township, N.J.). AtlantiCare launched an ACO in October 2011. The ACO, which is operated through AtlantiCare Health Solutions, a non-profit corporation in New Jersey, includes participation from partner payors and independent and employed physicians. The AtlantiCare system includes more than 600 physicians and AtlantiCare Regional Medical Center, a 567-bed teaching hospital.
Atlantic Health System ACO (Morristown, N.J.). Non-profit, four-hospital Atlantic Health formed a commercial ACO in December 2010. In April, CMS selected the ACO to participate in the Medicare Shared Savings Program. Operating as the AHS ACO, about 50,000 Medicare beneficiaries will be covered by the model. The ACO includes a partnership with Valley Hospital in Ridgewood, N.J., and participation from more than 1,300 physicians, including more than 200 primary care providers.
Atrius Health (Boston). Atrius is the largest independent, non-profit physician group in Massachusetts, comprised of approximately 1,000 physicians. In late 2011, it was selected by CMS to participate in the Pioneer ACO model. Five of Atrius Health's six medical groups are participating in the ACO: Dedham Medical Associates, Granite Medical Group, Harvard Vanguard Medical Associates, South Shore Medical Center and Southboro Medical Group. Reliant Medical Group is considering participation in the ACO, as it recently joined Atrius in October 2011.
Banner Health (Phoenix). The Banner Health Network was the first organization accepted by CMS into the agency's Pioneer ACO program in late 2011. The network includes Banner Health-affiliated physicians, 13 Banner hospitals — with 12 in the metropolitan Phoenix area — and other Banner services throughout Arizona. The ACO is a partnership between Arizona Integrated Physicians, Banner Medical Group and Banner Physician Hospital Organization. In total, it includes more than 2,600 primary care and specialty physicians.
Bellin-ThedaCare Healthcare Partners (Green Bay, Wis.). Bellin Health, ThedaCare and independent physicians were selected to work together as a Pioneer ACO by CMS in late 2011. The two health systems have a history of collaboration. They formed the Northeast Wisconsin Health Value Network in 2008, which was recently renamed as Bellin Health-ThedaCare Healthcare Partners. It includes eight major healthcare facilities between the two systems along with roughly 700 affiliated physicians.
Beth Israel Deaconess Physician Organization (Boston). The Beth Israel Deaconess Physician Organization was selected to participate in CMS' Pioneer ACO program in late 2011. The group has more than 1,600 physicians, including upwards of 350 primary care providers. It is affiliated with Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School, as well as several community hospitals in the region.
Bon Secours Medical Group (Richmond, Va.). Bon Secours Medical Group, the physician practice of Bon Secours Virginia Health System, launched an ACO with Cigna in April 2012. The model is based on the patient-centered medical home model of care, under which primary care physicians are rewarded for improved outcomes and lowered medical costs. The initiative covers approximately 8,000 Cigna beneficiaries.
Bronx Accountable Healthcare Network (New York City). Bronx Accountable Healthcare Network is affiliated with Montefiore Medical Center and was named to participate in the Pioneer ACO program in late 2011. CMS has estimated that roughly 24,000 Medicare beneficiaries will be served by the Montefiore ACO due to their current or past visits with one or more of the system's 2,400 employed and community-based physicians. This ACO is the only Pioneer ACO in New York state.
Brown & Toland Physicians (San Francisco). Brown & Toland Physicians was named as a Pioneer ACO in late 2011 by CMS. The independent practice association is comprised of more than 1,500 physicians and is affiliated with six hospitals in the San Francisco Bay Area.
Carilion Clinic (Roanoke, Va.). Carilion announced the formation of its ACO with Hartford, Conn.-based Aetna in March. The ACO will result in co-branded commercial healthcare plans for businesses and individuals, new payment models, shared cost savings, and joint opportunities to personalize care needs of patients, including Virginia's Medicaid beneficiaries. Aetna serves roughly 35.3 million people, and Carilion serves nearly 1 million through its hospitals, outpatient specialty centers and advanced primary care practices.
Catholic Healthcare West (San Francisco). Along with San Ramon, Calif.-based Hill Physicians and Blue Shield of California, CHW launched a program to manage the care of more than 40,000 members of the California Public Employees' Retirement System. The collaboration, which was announced in April 2009 and went live in January 2010, essentially operates as an ACO. CalPERS members who already had a primary care physician affiliated with Hill were automatically enrolled in the program, which aims to improve what the providers considered a disjointed delivery system.
Chinese Community Accountable Care Organization (New York City). The Chinese Community ACO, a participant in the Medicare Shared Savings Program, will operate in the Chinese community of New York City. Through physician collaborations, the ACO is focused on providing culturally competent care to patients in an underserved, minority population. New York hospitals involved in the collaboration include Beth Israel Medical Center, New York Hospital Queens, Lutheran Medical Center and Flushing Hospital. The ACO is expected to cover about 12,000 Medicare beneficiaries.
CIPA Western New York IPA (Buffalo, N.Y.). This ACO will do business as Catholic Medical Partners, which is a Buffalo, N.Y.-based partnership between Catholic Health, St. Mary's Hospital and a network of more than 900 independent physicians. A participant in the Medicare Shared Savings Program, the ACO will serve roughly 31,000 beneficiaries.
Coastal Carolina Quality Care (New Bern, N.C.). Coastal Carolina Health Care — a physician-owned, multi-specialty group with more than 50 providers — is the sole participant in this ACO. Recently named to participate in the Medicare Shared Savings Program, CCQC is expected to serve about 11,000 Medicare beneficiaries. Care for Medicare patients accounts for more than half of the medical group's care delivery.
Crystal Run Healthcare ACO (Middletown, N.Y.). A multispecialty group with more than 200 providers, Crystal Run Healthcare spans more than 40 medical specialties and includes 15 practice locations. Its ACO, which is participating in the Medicare Shared Savings Program, is expected to cover approximately 10,000 beneficiaries in New York and Pennsylvania.
Dartmouth-Hitchcock (Lebanon, N.H.). Dartmouth-Hitchcock was selected to participate in CMS' Pioneer ACO program in late 2011. Previously, Dartmouth-Hitchcock has also participated in CMS' Physician Group Practice Demonstration and Transition Demonstration Projects, as well as other ACO models with three major insurers: Anthem, Cigna and Harvard Pilgrim Health Care. The Dartmouth-Hitchcock Clinic includes more than 1,200 primary and specialty care physicians throughout New Hampshire and Vermont.
Doctors Medical Center (Modesto, Calif.). In June 2011, Doctors Medical Center announced the launch of a three-year ACO with San Francisco-based Blue Shield of California and Modesto-based AllCare Independent Physician Association. The program covers approximately 8,000 HMO members. The healthcare entities share clinical and case management information to coordinate services, and incentives are aligned to improve quality and patient service while reducing costs.
Eastern Maine Healthcare Systems (Brewer.). Eastern Maine was one of the first 32 Pioneer ACOs in the country, a CMS program that went into effect in January 2012. Its ACO includes approximately 8,000 Medicare beneficiaries who see providers based at three hospitals within the EMHS system — Aroostook Medical Center in Presque Isle, Eastern Maine Medical Center in Bangor, and Inland Hospital in Waterville. The system — which includes nursing homes, integrated physician groups and home health organizations — has said more than 60 percent of its revenue comes from Medicare and MaineCare.
Fairview Health Services (Minneapolis). Fairview, a 10-hospital system, was selected to participate in the CMS Pioneer ACO program in late December 2011. Fairview has pursued the ACO model through its Fairview Health Network for the past few years. In July 2009, the system signed performance-based contracts with Medica and continued to pursue similar deals with other major payors. Approximately 363 providers from 46 Fairview Health sites are participating in the Pioneer ACO, which includes more than 19,000 Medicare beneficiaries.
Florida Physicians Trust (Winter Park). This ACO includes a diverse group of independent physicians, including doctors of medicine and doctors of osteopathic medicine. The physicians will focus on care coordination, team-based care and improved provider-patient communication. The ACO, which was named as one of the first 27 ACOs to participate in the Medicare Shared Savings Program, is expected to serve about 16,500 beneficiaries.
Franciscan Alliance (Mishawaka, Ind.). The 13-hospital system formed an ACO in February 2010 and was named one of the first 32 Pioneer ACOs by CMS in late December 2011. The Pioneer ACO covers 22,000 Medicare patients in central Indiana and includes more than 700 physicians, 180 of whom are employed. The others are independent physicians who agreed to coordinate care as part of the ACO. Franciscan Alliance took its first step toward ACO formation in late 2010 when it forged an agreement with Anthem Blue Cross and Blue Shield to provide patients enrolled in Hoosier Healthwise and the Healthy Indiana Plan with access to a more integrated system.
Genesys Physician Hospital Organization (Flint, Mich.). Genesys PHO is a collaboration between Genesys Health System and Genesys Physicians Group Practice. In late 2011, CMS named the PHO to participate in the CMS Pioneer ACO program. Genesys Health System, which includes Genesys Regional Medical Center at Health Park, is part of Ascension Health, the country's largest Catholic health system.
Hackensack (N.J.) Physician-Hospital Alliance ACO. HackensackUMC, the non-profit, 775-bed teaching hospital, is the anchor of this ACO. The Physician-Hospital Alliance ACO includes 735 physicians and advanced practice nurses. The integrated Hackensack system includes a cancer center, children's hospital, women's hospital and heart hospital. Named to participate in the Medicare Shared Savings Program, the Hackensack ACO will cover approximately 11,000 beneficiaries.
Health Choice (Memphis). A physician hospital organization affiliated with Memphis, Tenn.-based Methodist Le Bonheur Healthcare, Health Choice launched a collaborative accountable care initiative with Cigna in September 2011. The ACO covers approximately 17,000 Cigna health plan members who receive care from 29 Health Choice physicians at seven participating practice locations. The program was the first patient-centered ACO in the Memphis area between independent medical practices and a health plan.
Healthcare Partners Medical Group (Torrance, Calif.). CMS named Healthcare Partners Medical Group to participate in the Pioneer ACO program in late 2011. The group includes more than 1,200 employed and affiliated primary care physicians and more than 30,000 employed and contracted specialists. Prior to its participation in the Pioneer ACO program, the medical group also announced its participation in a commercial ACO with Irvine, Calif.-based Monarch Healthcare and Anthem Blue Cross.
HealthCare Partners of Nevada (Las Vegas). HealthCare Partners of Nevada is a multispecialty medical group and independent physician association that includes more than 203 primary care physicians and more than 1,700 specialists. In late 2011, CMS named the group to participate in the Pioneer ACO program to reduce costs and enhance care coordination for Medicare beneficiaries.
Heritage California ACO (Northridge, Calif.). Heritage California ACO is operated by the Heritage Provider Network, which is a collaboration of 10 affiliated medical groups and independent physician associations. The Heritage Provider Network contracts 2,300 primary care physicians, 30,000 specialists and more than 100 hospitals. The ACO's service area spans eight counties in North, Central and Coastal California.
Hoag Memorial Hospital Presbyterian (Newport, Calif.). Hoag Memorial formed a three-year ACO with Blue Shield of California and Greater Newport Physicians Medical Group. GNP Medical Group includes more than 500 physicians, who mainly deliver care at Hoag. Under the initiative, the organizations will share clinical and case management information, coordinate healthcare services and align incentives to reduce costs and improve quality. The ACO will officially go into effect July 1, 2012.
Jackson Purchase Medical Associates (Paducah, Ky.). This ACO is comprised of six medical groups throughout the Jackson Purchase region of Kentucky, including walk-in centers and specialists in endocrinology, rheumataology and renal care. Recently named to participate in the Medicare Shared Savings Program, the Jackson Purchase ACO is expected to cover roughly 6,000 Medicare beneficiaries.
Jordan Community ACO (Plymouth, Mass.). The Jordan Community ACO is a non-profit organization consisting of more than 100 physicians from Plymouth Bay Medical Associates, Jordan Physician Associates and specialists from Jordan Hospital, also located in Plymouth. Together, the physicians will coordinate care for more than 6,000 Medicare beneficiaries, since CMS named the ACO as one of the first 27 participants in the Medicare Shared Savings Program.
JSA Medical Group (Saint Petersburg, Fla.). JSA Medical Group includes 34 primary care practices in the greater Tampa Bay and Orlando areas, along with affiliations with more than 50 primary care practices. The group includes 184 primary care physicians and roughly 1,800 specialists. In late 2011, CMS named JSA Medical Group as one of the first 32 Pioneer ACOs in the country.
Kaleida Health (Buffalo, N.Y.). In April, Kaleida Health announced its participation in a commercial accountable care initiative with BlueCross BlueShield of Western New York. The model, which is the first of its kind in the Buffalo region, includes a network of Western New York physicians who will contract with Kaleida and BCBS to create a physician-led organization.
Methodist Health System (Dallas). In May 2011, Methodist partnered with Texas Health Resources, based in Arlington, to develop a multi-provider ACO. Doug Hawthorne, CEO of Texas Health Resources, said the non-profit health systems both have strong faith-based foundations and are anchored in complementary locations. Prior to the announcement, the organizations participated in ACO preparatory projects with Premier, a national healthcare performance improvement alliance.
Michigan Pioneer ACO (Detroit). The Michigan Pioneer ACO is anchored by Detroit Medical Center and includes more than 200 employed and affiliated primary care and specialist physicians who provide services to Medicare patients through the hospital. DMC was one of the first hospitals in the country to successfully go entirely "paperless" with an electronic medical record in 2008. Late last year, CMS named the Michigan Pioneer ACO as one of the first 32 Pioneer ACOs in the country.
Monarch Healthcare (Irvine, Calif.). Monarch Healthcare, an independent practice association, was named one of the first 32 Pioneer ACOs by CMS in late 2011. Monarch is the largest physician organization in Orange County with more than 2,300 private practice physicians who care for roughly 176,000 people. In May 2010, Monarch also announced its participation in an ACO pilot project led by The Dartmouth Institute for Health Policy and Clinical Practice. That pilot was a comprised of a partnership between Monarch, Anthem Blue Cross and HealthCare Partners, an IPA based in Torrance, Calif.
Mount Auburn Cambridge Independent Practice Association (Brighton, Mass.). Mount Auburn Cambridge IPA was named one of the first 32 Pioneer ACOs by CMS in late 2011. The ACO includes the IPA as well as Mount Auburn Hospital, a teaching hospital in Cambridge, Mass. The IPA includes more than 500 physicians. Mount Auburn Hospital has also formed risk-based contracts with Blue Cross Blue Shield of Massachusetts, Tufts Health Plan and Harvard Pilgrim Health Care.
North Country ACO (Littleton, N.H.). Participants in the North Country ACO include Ammonoosuc Community Health Services, Coos County Family Health Services, Indian Stream Health Center and Mid-State Health Center. All ACO participants are members of the rural health network North Country Health Consortium, which was founded in 1997. The ACO, which was selected to participate in the Medicare Shared Savings Program, is expected to cover about 6,000 beneficiaries.
Norton Healthcare (Louisville, Ky.). In November 2010, Norton partnered with insurer Humana to create the first ACO in the Louisville area. Non-profit Norton is comprised of five Louisville hospitals with approximately 2,300 physicians on its medical staff. The ACO was launched as part of the Brookings-Dartmouth ACO Pilot Project.
North Texas ACO (Fort Worth and Arlington). North Texas Specialty Physicians and Texas Health Resources were selected by CMS to participate in the Pioneer ACO program in late 2011. NTSP is an independent physician association including more than 600 primary care and specialty physicians caring for patients in four Texas counties. THR is one of the largest faith-based, non-profit health systems in the country with 24 hospitals.
OhioHealth (Columbus). In June 2011, OhioHealth announced its collaboration with Ohio-based health insurer Medical Mutual and the Medical Group of Ohio to form the Health4 program, which functions as an ACO. The 18-hospital system first formed Health4 with MGO in 2009. The partnership focused on a clinically integrated pay-for-quality approach to healthcare. The payor's recent addition to the partnership allows Health4 physicians and hospitals to be financially rewarded when quality measures are met and savings are realized.
Optimus Healthcare Partners (Summit, N.J.). This physician-led ACO includes more than 500 primary and specialty physicians. Named a participant in the Medicare Shared Savings Program by CMS, Optimus Healthcare Partners will serve beneficiaries in 11 New Jersey counties. In an April news report from NJ Spotlight, Optimus Healthcare CEO Thomas Kloos, MD, has said he expects to start with 27,000 Medicare patients and hopes to enroll commercial payors and increase the patient population to about 100,000 by the end of 2012.
OSF Healthcare System (Peoria, Ill.). OSF Healthcare was selected in December 2011 to participate in CMS' Medicare Pioneer ACO program. The health system uses care managers to help coordinate patient care from service points within the healthcare continuum. OSF Healthcare has a primary care physician network consisting of more than 600 PCPs, specialists and advanced practitioners. It also includes an extensive network of home health services, known as OSF Home Care Services, for patients' post-acute care needs.
Park Nicollet Health Services (St. Louis Park, Minn). Park Nicollet was named one of the first 32 Pioneer ACOs by CMS late last year. The system has more than 1,000 physicians on staff and includes the 426-bed Park Nicollet Methodist Hospital, 29 multi-specialty clinics, a research foundation and an international diabetes center. The system previously participated in CMS' five-year Physician Group Practice Demonstration. In its fifth year, Park Nicollet achieved benchmark performance on all 32 quality measures.
Partners HealthCare (Boston). Partners was one of the first 32 organizations to participate in CMS' Pioneer ACO model. The system's background with care coordination stems back to 2006, when the system's Massachusetts General Hospital in Boston launched the Care Management Program, one of six CMS demonstration projects in the country. The program was found to be so successful — for every dollar spent, the program saved $2.65 in healthcare costs — that in 2009, CMS renewed it for another three years and expanded it to two more Partners hospitals: Brigham and Women's Hospital in Boston and North Shore Medical Center in Salem, Mass.
Physician Health Partners (Denver). Physician Health Partners is a medical management company, and it was named to participate as a Pioneer ACO by CMS along with three of its strategic partner independent practice associations. Those IPAs are Primary Physician Partners, South Metro Primary Care and KEY Primary Care Physicians. The model focuses on medical homes and consists of more than 260 primary care physicians.
Physicians of Cape Cod ACO (Hyannis, Mass.). The Physicians of Cape Cod ACO has been pursing care coordination for beneficiaries through its managed care program since 2002. The ACO was recently approved by CMS to participate in the Medicare Shared Savings Program — the first of 27 ACOs to do so. It is expected to cover about 5,000 Medicare beneficiaries in the Cape Code area.
Piedmont Physicians Group (Atlanta). Part of non-profit Piedmont Healthcare, Piedmont Physicians Group launched a pilot ACO with Cigna in July 2010. The ACO covers about 10,000 people in Cigna health plans. Under the pilot, Cigna pays the providers of Piedmont Physicians Group — which includes more than 100 primary care physicians — as usual for medical services, along with an additional fee for care coordination and medical home services. Physicians also get bonus payments if they meet targets for better quality and lower costs.
Premier ACO Physician Network (Calif.). The Premier ACO Physician Network is a subsidiary of Lakewood IPA, which has served patients in the Long Beach and Orange County areas for 25 years. Premier ACO Physician Network was recently selected by CMS to participate in the Medicare Shared Savings Program. It is expected to cover approximately 12,500 beneficiaries.
Presbyterian Healthcare System (Albuquerque, N.M.). Presbyterian was named one of the first 32 Pioneer ACOs by CMS in late 2011. The non-profit, eight-hospital system is also the largest managed care organization in the state, providing commercial health insurance along with Medicare and Medicaid products. It employs more than 500 physicians and practitioners, and its medical group has more than 30 locations throughout the state.
Primary Partners (Fla.). Primary Partners includes participating physicians from four Florida counties: Lake, Orange, Osceola and Polk. The ACO will offer clinically integrated patient-centered care while primary care physicians continue operating their independent practices. In April, CMS named Primary Partners as one of the first 27 ACOs to participate in the Medicare Shared Savings Program. The ACO is expected to serve about 7,500 beneficiaries.
Primecare Medical Network (San Bernardino, Calif.). Primecare Medical Network consists of 12 independent practice associations and two medical groups with more than 200 primary care physicians and 1,000 specialists. The network has participated in multiple health plan pay-for-performance quality programs and was named as one of the first 32 Pioneer ACOs by CMS in late 2011. The network operates in California's Riverside, San Bernardino and San Diego counties.
ProHealth Care (Waukesha, Wis.). In October 2010, ProHealth partnered with Waukesha Elmbrook Health Care, a local independent physician association, to form the first ACO in southeast Wisconsin. The ACO, called ProHealth Solutions, includes more than 475 physicians. Other participants in the model include Waukesha Memorial Hospital, Oconomowoc Memorial Hospital and ProHealth's behaviorial health, home care and hospice facilities.
ProMed Alliance (Dade County, Fla.). ProMed Alliance, a subsidiary of Peer Review Mediation & Arbitration, a medical services business development company, formed an accountable care organization in March 2012. The ACO will include 10 to 15 primary care physicians, 15 to 20 specialists, and an advanced diagnostic and surgery center. The ACO is the first of 50 PRMA and ProMed plan to develop across the country over the next five years.
RGV ACO Health Providers (Donna, Texas.). Comprised of six primary care group practices, the RGV ACO serves patients from six Texas counties and their surrounding communities. This ACO is designed to provide patients with 24-hour access to providers at 10 clinic locations through the implementation of medical home concepts. Recently named by CMS as a participant in the Medicare Shared Savings Program, the ACO is expected to serve more than 6,000 beneficiaries.
Renaissance Medical Management Company (Wayne, Pa.). Founded in 1998, RMMC is an independent practice association owned and managed by primary care physicians in Southeastern Pennsylvania. In late 2011, the IPA was selected by CMS to participate in the Pioneer ACO program. The IPA includes more than 200 primary care physicians across five counties.
Santa Clara County Individual Practice Association (San Mateo, Calif.). SCCIPA and Anthem Blue Cross of California formed an ACO in August 2011 to provide care for Anthem PPO members in the Silicon Valley. The medical group includes 284 primary care physicians, 550 specialists and ten acute-care facilities throughout Santa Clara County. The clinic has been said to "operate like a clinic without walls," in that it coordinates patients and health plans through an established network of medical services and providers.
Seton Health Alliance (Austin, Texas). Seton Health Alliance is an open network of providers currently made up of Seton Healthcare Family, an 11-hospital system, and Austin Regional Clinic. The ACO serves an 11-county region in Central Texas that includes 13 hospitals. In late 2011, Seton Health Alliance was named a participant in the Pioneer ACO program by CMS.
Sharp Healthcare System (San Diego). Sharp HealthCare was selected by CMS as one of the first 32 Pioneer ACOs, effective in 2012. The ACO includes 836 physicians and 52 mid-level providers and covers approximately 32,000 beneficiaries. A key goal of the ACO is the reduction of preventable readmissions across seven Sharp hospitals, an initiative addressed through care transitions programs, skilled nursing programs and end-of-life care services.
St. John Providence Health System (Warren, Mich.). In October 2011, St. John Providence formed a physician-led ACO in a 50-50 partnership with The Physician Alliance, which is comprised of six independent physician groups — or more than 2,300 physicians — in Michigan. The ACO is called St. John Providence Partners in Care and is expected to cover approximately one million patients in five counties.
St. John's Mercy Medical Group (St. Louis). St. John's Mercy Medical Group, a physician-led practice including 165 primary care physicians affiliated with St. John's Mercy Health Care, launched an accountable care pilot program with Cigna in July 2010. The ACO uses registered nurse case managers to serve as clinical care coordinators for Cigna beneficiaries, and physicians are rewarded through pay for performance structures if they meet metrics for quality and medical costs.
St. Joseph Health System (Orange, Calif.). St. Joseph Health System and Blue Shield of California launched a one-year accountable care initiative in January 2012. The model, which functions as an ACO, covers approximately 30,000 Blue Shield HMO members in Orange County. It involves St. Joseph Hospital in Orange, St. Jude Medical Center in Fullerton, Mission Hospital in Mission Viejo and Laguna Beach, a home health ministry, three medical groups and three affiliated physician networks.
Steward Health Care System (Boston). Steward Health Care System includes 10 community hospitals and serves more than one million patients across 85 Massachusetts communities. The system also includes a medical group and hospice and home care services. It was named a Pioneer ACO by CMS in late 2011.
TriHealth (Fort Dodge, Iowa). TriHealth's ACO is anchored by Trinity Regional Medical Center, Berryhill Center for Mental Health, Trimark Physicians Group and Iowa Health Home Care. TriHealth has an eight-county service area in a predominantly rural area of northwest central Iowa. In late 2011, CMS named TriHealth a participant in the Pioneer ACO program.
University of Michigan Health System (Ann Arbor). The University of Michigan Health System was named to participate as one of the first 32 Pioneer ACOs in late 2011. The ACO is a partnership with IHA Health Services Corporation, a multi-specialty group practice based in Ann Arbor with roughly 175 physicians. The three-hospital system has previously found success in the Medicare Physician Group Practice Demonstration, a five-year project in which U-M's Faculty Group Practice saved Medicare upwards of $22 million through medical cost reductions.
Weill Cornell Physician Organization (New York City). Weill Cornell, which includes approximately 71 physicians, launched an accountable care initiative with Cigna in January 2011. The initiative is essentially an accountable care organization since it shares the model's population health goals. It is the first patient-centered accountable care initiative in New York City involving a health plan and physician organization.
West Florida ACO (Trinity, Fla.). CMS named West Florida ACO as one of the first 27 participants in the Medicare Shared Savings Program this April. The ACO is made up of more than 30 primary care physicians and specialists who focus on care coordination for geriatric patients. Internist Jayadeva Chowdappa, MD, heads the ACO, which is expected to serve more than 10,000 Medicare beneficiaries.
Westmed Medical Group (Purchase, N.Y.). Westmed — a multi-specialty practice including more than 220 physicians — launched an ACO with UnitedHealthcare and Optum in March 2012. Participating physicians are measured and rewarded based on quality outcomes, patient satisfaction and cost reduction compared medical costs in the local market. Westmed has also received level-3 recognition for its patient-centered medical home from the National Committee for Quality Assurance.
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