100 Accountable Care Organizations to Know

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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 non-Medicare 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.

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 two-hospital 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 Health-Portland is part of Roseville, Calif.-based Adventist Health. The system announced a collaborative care initiative with Regence BlueCross BlueShield of Oregon in May 2013. 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.

Atlantic Accountable Care Organization (Morristown, N.J.). Atlantic ACO was one of the first 27 ACOs to become a participant in the Medicare Shared Savings Program. It covers more than 55,000 beneficiaries and includes four hospitals: Morristown (N.J.) Medical Center, Newton (N.J.) Medical Center, Overlook Medical Center in Summit, N.J., and The Valley Hospital in Ridgewood, N.J.

Atrius Health (Newton, Mass). Atrius is a nonprofit physician alliance with more than 1,000 physicians. CMS chose Atrius as one of the 32 Pioneer ACOs in 2011. Even though the Pioneer ACO did not achieve shared savings in its first performance year, officials say Atrius Health remains committed to the program.

Aurora Accountable Care Organization (Milwaukee). Milwaukee-based Aurora Health Care's Lakeshore Medical Clinic was selected as a Medicare Share Savings Program ACO in July 2012. Additionally, Aurora Health Care and Aetna launched an ACO in 2013: The Aurora Accountable Care Network. The ACO, which includes more than 1,500 providers, 15 hospitals and 160 clinics, offers plans to small- to mid-sized employers.  

Banner Health Network (Phoenix). Banner Health Network created a commercial accountable care product with Aetna in 2011. Later that year, it was the first organization accepted into CMS' Pioneer ACO program. BHN also has accountable care contracts with commercial payers like Humana and Cigna. The network includes Banner Health-affiliated physicians, Banner hospitals and other Banner services.

Baptist Health System (San Antonio). Baptist Health System is a five-hospital system in south Texas. Baptist Health and its clinically integrated physician network joined the Medicare Shared Savings Program in July 2012. As of April 2013, the ACO successfully completed 3,464 chart reviews in a six-week period to complete CMS' baseline Group Practicing Reporting Option Quality Audit, which helped identity further practices Baptist can adopt to improve population health.

Barnabas Health ACO-North (West Orange, N.J.). Barnabas Health ACO-North was selected to participate in the Medicare Shared Savings Program in summer 2012. It includes Barnabas' acute-care hospitals in northern New Jersey — Clara Maass Medical Center in Bellville, Newark Beth Israel Medical Center and Saint Barnabas Medical Center in Livingston — and their affiliated physicians.

BayCare Health System (Clearwater, Fla.). BayCare Health System's physician group, BayCare Physician Partners, launched two commercial ACOs in January 2013 — one with Cigna and one with Aetna. The contract with Cigna covers about 13,000 patients, and the Aetna ACO covers patients who received care from a BayCare Physician Partners provider within the last two years. BayCare Physician Partners has about 1,100 physicians.

Baylor Quality Alliance (Dallas). Baylor Quality Alliance is the clinically integrated network and ACO of Baylor Health Care System, which includes 27 owned, leased or affiliated hospitals. The ACO finalized a commercial coordinated care contract with Aetna in November 2012. BQA includes approximately 1,400 independent and 600 employed physicians.

Beacon Health (Brewer, Maine). Beacon Health is the Medicare Pioneer ACO of Eastern Maine Healthcare Systems, based in Brewer. EMHS' Pioneer ACO is named "Beacon Health" to reflect the success of the Bangor Beacon Community project, which improves health IT infrastructure and exchange capabilities in the community and was funded by the office of the National Coordinator for Health Information Technology. The ACO includes three EMHS hospitals and their affiliated providers: Aroostook Medical Center in Presque Isle, Eastern Maine Medical Center in Bangor and Inland Hospital in Waterville. The ACO covers about 8,000 Medicare beneficiaries.

Bellin-Thedacare Healthcare Partners (Green Bay, Wis.). Independent physicians partnered with Bellin Health and community health system ThedaCare, based in Neenah, Wis., to form Bellin Thedacare Healthcare Partners. The joint venture was selected to participate in CMS' Medicare Pioneer ACO in late 2011. The ACO includes eight major healthcare facilities and approximately 700 physicians.

Beth Israel Deaconess Care Organization (Westwood, Mass.). Beth Israel Deaconess Care Organization, the ACO affiliated with Beth Israel Deaconess Medical Center in Boston, includes more than 1,700 physicians. BIDCO is a Pioneer ACO. It saved 4.2 percent of its budget in the Pioneers' first performance year and generated a return of $7.79 million for itself.

Billings (Mont.) Clinic. Billings Clinic is a community-owned healthcare organization with a multispecialty physician group practice, a hospital and a skilled nursing and assisted living facility. Billings Clinic was selected as a Medicare Shared Savings Program ACO in January 2013. It also received ACO accreditation from the National Committee for Quality Assurance.

BJC HealthCare ACO (St. Louis). CMS chose BJC HealthCare ACO to participate in the Medicare Shared Savings Program in July 2012. The ACO has more than 100 healthcare delivery settings and delivers care through an integrated network of providers. Sandra A. Van Trease serves as president of BJC HealthCare's ACO.

Brown & Toland Physicians (San Francisco). Brown & Toland Physicians, an independent physician organization, was selected by CMS as a Pioneer ACO in late 2011. The ACO covers more than 18,000 Medicare beneficiaries and includes about 190 physicians. Brown and Toland Physicians helped generate savings for Medicare in its first performance year as a Pioneer.

Cape Cod Health Network ACO (Hyannis, Mass.). Cape Cod Health Network ACO is a collaboration between two-hospital Cape Cod Healthcare and Cape Cod Preferred Physicians. The organization was named as a Medicare Shared Savings Program ACO by CMS in January 2013.

Carolinas HealthCare System (Charlotte, N.C.). Carolinas HealthCare System has more than 791 care locations throughout North and South Carolina. The system participated in the Partnership for Care Transformation Readiness Collaborative with Premier, which was launched in 2013 to help organizations decide if they should pursue an ACO model. In April this year, the system announced a collaboration with Aetna to support patient-centered medical homes and other accountable care initiatives.

Cedars-Sinai Accountable Care (Beverly Hills, Calif.). Cedars-Sinai Accountable Care, which includes the 958-bed Cedars-Sinai Medical Center, was selected to participate in the Medicare Shared Savings Program in January 2013. Cedars-Sinai Medical Care Foundation providers are also participating in the MSSP ACO.

Chicago Health System ACO. Chicago Health System ACO became a Medicare Shared Savings Program ACO in July 2012. The organization is part of Vanguard Health Systems' Chicago Market, which includes four hospitals and a network of more than 100 physicians. The ACO had 9,700 attributed patients as of May 2013.

Children's Hospital of Philadelphia. The Children's Hospital of Philadelphia is one of the first six ACOs to be accredited by the National Committee for Quality Assurance. It is the only children's hospital to become an accredited ACO. CHOP earned ACO accreditation due to its infrastructure that supports quality improvements, patient-centered care and care coordination.

Cleveland Clinic Florida (Weston). Cleveland Clinic Florida is a nonprofit academic medical center with more than 215 physicians. In February 2013, the hospital and Blue Cross and Blue Shield company Florida Blue signed a letter of intent to form an ACO. The ACO plans to have a value-based compensation structure, rewarding physicians for transparency, care coordination and lack of redundancies.

Cornerstone Health Care (High Point, N.C.). Cornerstone Health Care is a physician-owned group with more than 360 providers. The group was named as a member of the Medicare Shared Savings Program in July 2012. It has several ACO contracts with private payers like Blue Cross and Blue Shield of North Carolina and UnitedHealthcare. In fact, as of May 2013, the group had value-based contracts with all of its payers.

Crystal Run Healthcare ACO (Middletown, N.Y.). Crystal Run Healthcare is a multispecialty group practice, that was formed in 1996 and has about 250 physicians. Crystal Run Healthcare ACO is one if the first Medicare Shared Savings Program participants, starting in April 2012, and is also one of the first six ACOs accredited as such by the National Committee for Quality Assurance.

Dartmouth-Hitchcock (Lebanon, N.H.). Dartmouth-Hitchcock is one of Medicare's original 32 Pioneer ACOs and covers slightly more than 17,000 patients. In its first performance year, the health system-anchored ACO saved enough money to receive about $1 million in shared savings from Medicare. Dartmouth-Hitchcock participated in the Medicare Physician Group Practice Demonstration, which preceded the Pioneer model, and has similar value-based arrangements with private payers. Additionally, Dartmouth-Hitchcock co-created OneCare Vermont with Fletcher Allen.

Dean Clinic and St. Mary's Hospital ACO (Madison). St. Mary's Hospital in Madison and its affiliated physician group with more than 100 physicians, Dean Clinic, formed a joint venture to launch an ACO, which joined the Medicare Shared Savings Program in July 2012. The ACO services patients in south central Wisconsin.

Diagnostic Clinic Walgreens Well Network (Tampa Bay, Fla.). Diagnostic Clinic Walgreens Well Network is a partnership between Walgreen Co. and Diagnostic Clinic, a multispecialty medical group that is a wholly owned subsidiary of Florida Blue. CMS accepted the organization as a Medicare Shared Savings Program participant in 2013. It is one of Walgreens' three MSSP ACOs.

Dignity Health (San Francisco). Dignity Health is the fifth largest hospital operator in the nation and has several accountable care efforts in motion. For instance, Dignity launched an ACO in Sacramento in 2010 with Blue Shield of California and Hill Physicians that covers more than 40,000 individuals. The system has another ACO contract with Blue Shield of California in San Francisco as well. Dignity also partnered with Phoenix-based Abrazo Health for a Medicare Shared Savings ACO, Arizona Care Network, in January 2013.

Essentia Health (Duluth, Minn.). Essentia Health was chosen in July 2012 to participate in the Medicare Shared Savings Program as an ACO with more than 33,000 covered lives. Additionally, Essentia's ACO is one of only six in the nation to receive ACO accreditation from the National Committee for Quality Assurance. As of January 2013, Essentia provides ACO care to more than 100,000 patients through multiple payer contracts.

Everett (Wash.) Clinic. Everett Clinic is a physician group practice with about 400 physicians. The group formed an ACO in November 2012 to serve Group Health's Medicare Advantage Members. The Everett Clinic provides care for about 4,750 Group Health members.

Fairview Health Systems (Minneapolis). Fairview was selected to participate in CMS' Pioneer ACO program late in December 2011, but the system pursued the ACO model even before that through its Fairview Health Network. There are more than 350 providers participating in Fairview's Pioneer ACO, which covers more than 18,000 Medicare beneficiaries.

Franciscan Alliance (Mishawaka, Ind.). Franciscan Alliance, a 13-hospital system, has three Medicare ACOs: one in the Pioneer program and two in the Medicare Shared Savings Program. Each is comprised of various Franciscan Alliance hospitals, affiliated physician groups and surgery centers. The Pioneer ACO covers more than 20,000 lives and is the only Pioneer in Indiana. The MSSP ACOs are the Franciscan AHN ACO, which joined the MSSP in July 2012, and Franciscan Union ACO.  

Genesys Physician Hospital Organization (Flint, Mich.). The Genesys Physician Hospital Organization, a collaboration between Genesys Health System and Genesys Physicians Group Practice, was created in 1994. It includes about 160 primary care and 400 specialist physicians. CMS selected the PHO as one of the original 32 Pioneer ACOs in late 2011.

Greater Baltimore Health Alliance (Towson, Md.). The Greater Baltimore Health Alliance is wholly owned by Greater Baltimore Medical Center Healthcare and anchored by the 310-bed GBMC. GBHA, the first ACO in Maryland to be led by a hospital, joined the Medicare Shared Savings Program in July 2012. GBHA also includes Greater Baltimore Medical Associates, Greater Baltimore Geriatric and Palliative Medicine and more than 90 primary care providers from eight independent practices.

Hackensack (N.J.) Alliance ACO. Hackensack University Medical Center, a nonprofit teaching hospital, anchors the Hackensack Alliance ACO. Hackensack Alliance was established to participate in the Medicare Shared Savings Program and was named one of the original MSSP participants in April 2012.

Health4 (Columbus). Health4 is a clinically integrated healthcare delivery model that includes about 1,600 physicians of The Medical Group of Ohio and OhioHealth's hospitals. The Health4 program was formed in 2009, and in 2011, it announced a collaboration with Medical Mutual, an Ohio-based health insurer. In 2012, Health4 launched a pay-for-quality initiative with Cigna, which will cover more than 17,000 Cigna enrollees.

HealthCare Partners California ACO (Torrance, Calif.). Healthcare Partners California ACO is affiliated with HealthCare Partners Medical group. The ACO includes more than 1,200 employed and affiliated primary care physicians and more than 30,000 employed and contracted specialists. The ACO was one of the original 32 Medicare Pioneer ACOs, but was one of nine to announce its departure from the Pioneer program in July 2013. It also has a commercial ACO agreement with Monarch Healthcare and Anthem Blue Cross.

HealthCare Partners of Nevada (Las Vegas). HealthCare Partners of Nevada is a multispecialty independent physician organization with more than 200 primary care physicians and roughly 1,700 specialists. The group was named to the Medicare Pioneer ACO program in late 2011, but was one of nine to announce its exit the Pioneer program in July 2013.

HealthPartners (Bloomington, Minn.). HealthPartners is comprised of a multispecialty group practice with more than 1,700 physicians and five hospitals. HealthPartners is part of The Northwest Metro Alliance, an ACO learning lab that is a collaboration between HealthPartners and Minneapolis-based Allina Health and covers more than 300,000 people. Additionally, HealthPartners is one of the first six organizations to receive ACO accreditation from the National Committee for Quality Assurance.

Health Management Associates (Naples, Fla.). HMA has 71 hospital locations in 15 states. In 2013, the company announced an accountable care delivery model with Florida Blue for patients specifically in Brevard County, Fla. The agreement includes Wuesthoff Medical Center-Melbourne (Fla.) and Wuesthoff Medical Center-Rockledge (Fla.) along with HMA's physicians. The initial partnership, announced in May, is expected to lead to further cooperation between HMA and Florida Blue.

Heartland Health (St. Joseph, Mo.). Heartland Health is an integrated health delivery system consisting of Heartland Regional Medical Center in St. Joseph and Heartland Clinic, a physician-led multispecialty medical group practice. The system was selected by CMS in July 2012 to participate in the Medicare Shared Savings Program. The ACO is anchored by 11 patient-centered medical homes that have been recognized by the National Committee for Quality Assurance.

Heritage California ACO (Northridge). Heritage California ACO is an affiliate of the Heritage Provider Network, which is a collaboration of 10 affiliated medical groups and independent practice associations. HPN has contracts with 2,300 primary care physicians, 30,000 specialists and more than 100 hospitals. Heritage California ACO is one of the 32 original and 23 remaining Pioneer ACO program participants.

Hoag Memorial Hospital Presbyterian (Newport Beach, Calif.). Hoag Memorial Hospital Presbyterian partnered with Greater Newport Physicians Medical Group, an independent practice association with more than 500 affiliated physicians, to form an ACO with Blue Shield of California in July 2012. The ACO covers about 11,000 Blue Shield HMO members. The contract between the three parties is good for a minimum of three years.

Holy Cross Hospital (Fort Lauderdale, Fla.). Holy Cross Hospital's clinically integrated group, Holy Cross Physician Partners, officially became a participant of the Florida Blue Accountable Care Program Jan. 1, 2013. The ACO covers about 4,100 lives and may expand to include the Holy Cross Hospital employee group in the future. Holy Cross Physician Partners has more than 230 primary care and specialty physicians.

Hunterdon Healthcare Partners (Flemington, N.J.). Hunterdon Healthcare Partners, the physician-hospital organization affiliated with Hunterdon Healthcare, has three commercial ACO contracts. Its contract with Aetna includes about 2,200 members in Hunterdon's employee benefits plan and about 5,700 Aetna members. The PHO also has an ACO contract with Cigna, covering about 6,500 members, and Horizon Blue Cross Blue Shield of New Jersey, which covers more than 18,000 lives.

Indiana University Health (Indianapolis). Indiana University Health is an academic medical center partnered with Indiana University School of Medicine. CMS selected Indiana University Health to participate in the Medicare Shared Savings Program as an ACO in July 2012. John Fitzgerald, MD, serves as the ACO's president and CEO.

John Muir Health (Walnut Creek, Calif.). John Muir Health is a three-hospital system that has both Medicare and commercial ACO contracts. John Muir joined the Medicare Shared Savings Program in July 2012. That same month, the system launched an ACO with Blue Shield of California that is scheduled to last for at least three years. The commercial ACO covers about 16,000 lives.

JSA Medical Group (Saint Petersburg, Fla.). JSA Medical Group is comprised of 34 primary care practices in the greater Tampa Bay and Orlando areas and has affiliations with more than 50 primary care practices. It was one of the first 32 organizations to be named a Pioneer ACO by CMS in 2011, but was also one of nine ACOs to announce its departure from the Pioneer ACO program in July 2013 after results from the ACOs' first performance year were released.  

Kelsey-Seybold Clinic (Houston). Kelsey-Seybold Clinic is a physician group with 21 locations and more than 370 board-certified physicians in 56 specialties. The group was one of the first six organizations to be recognized as an ACO by the National Committee for Quality Assurance in 2012. It also calls itself Houston's first ACO.

KentuckyOne Health Partners (Louisville, Ky.). KentuckyOne Health Partners is a physician-led clinically integrated network developed by KentuckyOne Health, which is the parent of Jewish Hospital and St. Mary's HealthCare and Saint Joseph Health System. KentuckyOne Health Partners was accepted into the Medicare Shared Savings Program in January 2013.

Key Physicians (Chapel Hill, N.C.). Key Physicians is a group of more than 220 independent physicians and 48 practice locations throughout North Carolina. The physician group has had ACO contracts with Cigna and Blue Cross and Blue Shield of North Carolina since 2012. Additionally, Key Physicians recently partnered with WakeMed Health in Raleigh, N.C., to form a Medicare ACO, WakeMed Key Community Care. That partnership applied for the Medicare Shared Savings Program with a start date of Jan. 1, 2014.

Lahey Clinical Performance ACO (Beverly, Mass.). Lahey Clinical Performance ACO is affiliated with Lahey Health, which includes Lahey Hospital & Medical Center, Beverly Hospital and more than 1,200 physicians. LCPN joined the Medicare Shared Savings Program in January 2013.

MaineHealth Accountable Care Organization (Portland). MaineHealth ACO was accepted into CMS' Medicare Shared Savings Program in July 2012. The system leveraged that ACO structure into an accountable care agreement with Anthem Blue Cross and Blue Shield for the state's first commercial ACO. The ACO has seven member hospitals and more than 1,000 physicians in southern Maine.

Memorial Hermann Health System (Houston). Memorial Hermann Health System is the largest nonprofit health system in southeast Texas with 12 hospitals and 5,500 affiliated physicians. The system, along with MHMD, the system's 332-physician network, joined the Medicare Shared Savings Program in July 2012. The Medicare ACO has the potential to reach 100,000 people in the Houston region. Memorial Hermann and MHMD also formed a commercial ACO with Aetna in April 2013.

Mercy Health Select (Cincinnati). Mercy Health Select is the managed care component of Cincinnati-based Mercy Health, a seven-hospital system. The ACO was selected to participate in the Medicare Shared Savings Program in July 2012. Mercy Health Select covers about 25,000 Medicare patients and is the only ACO in Cincinnati.

Methodist Le Bonheur Healthcare (Memphis, Tenn.). Methodist Le Bonheur Healthcare, a nonprofit, seven-hospital system, stepped into a five-year ACO agreement with BlueCross BlueShield of Tennessee effective Jan. 1, 2013. Additionally, Health Choice, a joint venture of MetroCare Physicians and Methodist Le Bonheur, launched a collaborative accountable care initiative with Cigna in 2011, which initially covered about 17,000 members.

Methodist Patient-Centered ACO (Dallas). The Methodist Patient-Centered ACO is backed by nonprofit Methodist Health System, which has four acute-care hospitals in the Dallas area. The ACO joined the Medicare Shared Savings Program in July 2012.

Michigan Pioneer ACO (Detroit). The Michigan Pioneer ACO is affiliated with Detroit Medical Center and includes more than 200 physicians. DMC was one of the first hospitals in the country to successfully go "paperless" with an electronic medical record in 2008. Michigan Pioneer ACO is one of the 32 original and 23 remaining Pioneer ACOs in the country.

MissionPoint Health Partners (Nashville, Tenn.). MissionPoint Health Partners is a clinically integrated network founded by St. Thomas Health in January 2012. MissionPoint Health Partners is also a Medicare Shared Savings Program ACO, starting in July last year. The organization has more than 1,500 physicians, covers more than 50,000 lives and is continuing to grow: Capella Healthcare's hospitals in middle Tennessee joined the MissionPoint network earlier this year.

Moffitt Cancer Center (Tampa, Fla.). Moffitt Cancer Center partnered with Florida Blue for a cancer-specific ACO that launched in 2013. The ACO focuses on "common cancers" and focuses on improving patient outcomes and quality of care while lowering healthcare costs, just like primary care ACOs. Moffitt serves hundreds of thousands of patients each year.

Monarch Healthcare (Irvine, Calif.). Monarch Healthcare is an independent practice association and one of the largest physician organizations in Orange County with more than 2,000 private practice physicians. The group was named a Pioneer ACO in 2011 and is one of 23 remaining in the program. Monarch also participated in an ACO pilot project led by The Dartmouth Institute for Health Policy and Clinical Practice.

Montefiore ACO (New York City). This ACO is affiliated with the Montefiore Medical Center and is a Pioneer ACO, covering about 23,000 Medicare beneficiaries. Montefiore ACO had the best financial performance of any Pioneer ACO in 2012. Additionally, Montefiore Medical Center formed an ACO agreement with Empire BlueCross BlueShield in September 2012.

Mount Auburn Cambridge Independent Practice Association (Brighton, Mass.). Mount Auburn Cambridge IPA is a Medicare Pioneer ACO. The ACO includes the IPA, which has more than 500 physicians, and Mount Auburn Hospital, a teaching hospital in Cambridge, Mass.

NCH Healthcare System (Naples, Fla.). NCH Healthcare System, a nonprofit two-hospital system, signed an ACO agreement with Florida Blue that began in 2013. The first year of the agreement will cover Florida Blue members participating in fully insured commercial products, but the ACO will eventually expand to other Florida Blue members. The agreement includes the NCH Healthcare Group, which is comprised on 64 physicians and 25 nurse practitioners and physician assistants.

Northwest Ohio ACO (Toledo). The Toledo Clinic and the University of Toledo Physicians teamed up to form this ACO, which was accepted by CMS as a Medicare Shared Savings ACO in January 2013. The Toledo Clinic is a group of about 140 physicians in 35 specialties, and UT Physicians has about 160 physicians and is affiliated with the University of Toledo Medical Center.

Novant Health (Winston-Salem, N.C.). Novant Health, a 13-hospital system with a medical group comprised of more than 1,100 physicians, launched a collaborative accountable care initiative with Cigna in April 2013. This CAC initiative is Cigna's largest, covering more than 60,000 members.

Ochsner Accountable Care Network (New Orleans). The Ochsner Accountable Care Network is an ACO that spans Louisiana and includes seven hospitals, 38 health centers and more than 900 primary care and specialty physicians. The organization was named as a Medicare Shared Savings Program participant in January 2013 and covers about 21,000 Medicare beneficiaries. Ochsner Clinic in Jefferson, La., a member of OACN, also has an accountable care contract with Cigna.

OneCare Vermont (Colchester, Vt.). OneCare Vermont was created jointly by Dartmouth-Hitchcock in Lebanon, N.H., and Fletcher Allen Health Care in Burlington, Vt. It is a Medicare Shared Savings Program ACO that coordinates care for about 42,000 of the state's 118,000 Medicare beneficiaries. The organization joined the shared savings program in January 2013.

Optimus Healthcare Partners (Summit, N.J.). Optimus Healthcare Partners is an ACO formed by Vista Health System IPA and the Central Jersey Physician Network. The ACO, which includes more than 500 physicians, joined the Medicare Shared Savings Program in April 2012. It also has some commercial ACO contracts, with payers like Horizon Blue Cross Blue Shield of New Jersey and Aetna. All together, the ACO covers approximately 80,000 beneficiaries.

Orlando (Fla.) Health. Orlando Health, a nonprofit eight-hospital system, joined the Medicare Shared Savings Program in January 2013 as Collaborative Care of Florida. Additionally, 532 physicians in the system's affiliated group, Orlando Health Physician Partners, launched an ACO with Cigna in January. The Cigna agreement covers about 24,000 patients.

OSF Healthcare System (Peoria, Ill.). OSF Healthcare System's medical centers, physicians, advanced care practitioners and home care services comprise the OSF Healthcare System Pioneer ACO. The Medicare ACO improved quality of care while reducing costs by 1 percent for its Medicare beneficiaries. In addition to its Medicare contract, OSF Healthcare has an ACO agreement with Blue Cross and Blue Shield of Illinois that will cover nearly 40,000 patients starting Jan. 1, 2014.

Park Nicollet Health Services (St. Louis Park, Minn.). Park Nicollet is one of the original 32 Pioneer ACOs, but has been involved in accountable care efforts since well before CMS named it to the program late in 2011. The system participated in CMS' Physician Group Practice Demonstration, in which it achieved benchmark performance on all 32 quality measures. In 2012, Park Nicollet established an ACO with nonprofit payer Medica.

Partners HealthCare (Boston). The integrated system of Partners HealthCare, which includes Brigham and Women's Hospital and Massachusetts General Hospital, is one of the original 32 and remaining 23 Medicare Pioneer ACOs. Partners covers about 52,000 Medicare patients in its Pioneer ACO, and the system earned $14.4 million in shared savings after its first performance year.

Penn Medicine (Philadelphia). Penn Medicine is comprised of several hospitals, including the Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital, and PennCare primary care practices. Penn Medicine joined the Independence Blue Cross' pay-for-performance and accountable care payment model in 2013. IBC is paying Penn Medicine physicians for their adherence to evidence-based guidelines and reductions in hospital-acquired infections and readmissions.

Physician Health Partners (Denver). Physician Health Partners is a medical management company, and CMS selected it as one of the 32 original Pioneer ACOs in late 2011. The group works with more than 300 physicians to coordinate care. Physician Health Partners decided to leave the Pioneer program in July 2013, but is still committed to working with CMS by participating in the Medicare Shared Savings Program.

Physician Organization of Michigan ACO (Ann Arbor). The Physician Organization of Michigan ACO, or POM ACO, joined the Medicare Shared Savings Program in 2013. The ACO includes more than 1,800 physicians and covers more than 80,000 Medicare beneficiaries. Three-hospital University of Michigan Health System also had a Pioneer ACO, but in July 2013, the ACO's physicians announced plans to join the MSSP model, POM ACO.

Plus (Fort Worth and Arlington, Texas). North Texas Specialty Physicians and Texas Health Resources were selected to participate in the Medicare Pioneer ACO program in 2011. NTSP is an independent physician association with more than 600 physicians, and THR is a nonprofit health system with 25 hospitals. The Plus Pioneer ACO was one of nine to announce its exit from the program in July 2013.

PrimeCare Medical Network (Ontario, Calif.). PrimeCare is a large network of independently contracted physicians. The group, which includes more than 425 primary care physicians and more than 2,000 specialists, was selected as one of the 32 original Pioneer ACOs. In July 2013, PrimeCare announced it would exit the Pioneer program.

ProHealth Physicians (Farmington, Conn.). ProHealth Physicians is a healthcare delivery system with more than 300 primary care providers. The network joined the Medicare Shared Savings Program in January 2013. A few months later, ProHealth signed an accountable care agreement with Aetna. That agreement includes Aetna's commercial members and Medicare Advantage members.

ProMedica (Toledo). In 2012, ProMedica started participating in the Medicare Shared Savings Program as an ACO. The ACO has 237 ProMedica Physicians providers who serve more than 14,000 patients. The ACO was built on ProMedica's patient-centered medical home care model, which was recognized by the National Committee for Quality Assurance.

Providence Health & Services, Southern California (the San Fernando Valley). Providence Health & Services, Southern California, which operates five acute-care hospitals, partnered with its affiliates Facey Medical Foundation and Facey Medical Group to form an ACO with Blue Shield of California. Facey Medical Group employs more than 160 physicians, and Facey Medical Foundation operates 10 multispecialty group clinics and two urgent care centers. The ACO covers about 16,500 Blue Shield HMO members. The contract will continue through 2015.

Renaissance Health Network (Wayne, Pa.). The Renaissance Health Network is a clinically-integrated, physician-owned company with more than 250 family practice and internal medicine physicians throughout five counties in Pennsylvania. It is the only Pioneer ACO in Pennsylvania. RHN also has a pay-for-performance arrangement with Keystone Health Plan East, an Independence Blue Cross plan.

Scott & White Healthcare Walgreens Well Network (Temple, Texas). The Scott & White Walgreens Well Network is a partnership between Walgreens and Scott & White Healthcare, a physician-led system with more than 1,000 providers. Scott & White Walgreens Well Network became a Medicare Shared Savings Program member in January 2013, making it one of three Medicare ACOs involving Walgreens.

Seton Health Alliance (Austin, Texas). Seton Health Alliance is a network of providers, including Seton Healthcare Family, an 11-hospital system, and Austin Regional Clinic. The group was selected as one of the original 32 Pioneer ACOs by CMS, but decided to leave the program in July 2013.

Sharp HealthCare (San Diego). Sharp HealthCare was selected as Pioneer ACO in 2011. The system serves about 32,000 Medicare beneficiaries each year. Sharp's ACO includes seven hospital locations and two medical groups: Sharp Community Medical Group and Sharp Rees-Stealy Medical Group.

St. Luke's Clinic Coordinated Care (Boise, Idaho). St. Luke's Clinic Coordinated Care is the ACO of St. Luke's Health System and is a joint venture between the system's hospitals and physicians. The organization was accepted into the Medicare Shared Savings Program in January 2013. It was the first Idaho-based ACO to be accepted into the program.

Steward Promise (Boston). Steward Promise is the Medicare Pioneer ACO of Steward Health Care System. Steward Health Care System includes 10 community hospitals and serves more than 1 million patients across 85 communities in Massachusetts. The ACO includes more than 2,400 care providers.

Texas Health Resources (Arlington). Texas Health Resources is a network of 25 hospitals in the Dallas-Fort Worth area and includes more than 5,500 physicians with staff privileges. Texas Health announced two ACOs with commercial payers in January 2013: Aetna and Blue Cross Blue Shield of Texas. Texas Health's ACO with Aetna includes members in 10 counties, while the BCBSTX ACO includes members in 12 counties. Texas Health was involved in a Medicare Pioneer ACO, but was one of nine ACOs to announce its departure from the program in July 2013.

Triad HealthCare Network (Greensboro, N.C.). The Triad HealthCare Network is a physician-led collaboration encompassing physicians employed by Greensboro-based Cone Health and other providers in the community. THN became a member of the Medicare Shared Savings Program in July 2012. More than half of the ACO's affiliated physicians are in private practice.

UCLA Health ACO (Los Angeles). UCLA Health ACO is anchored by UCLA Health, which is comprised of the Ronald Regan UCLA Medical Center, UCLA Medical Center Santa Monica, Resnick Neuropsychiatric Hospital at UCLA and Mattel Children's Hospital UCLA, as well as the UCLA Medical Group. The system, which includes more than 2,000 physicians, was chosen to participate in the Medicare Shared Savings Program in January 2013.

UnityPoint Health (Des Moines, Iowa). UnityPoint Health, formerly Iowa Health System, is involved in two Medicare accountable care models: the Pioneer ACO model and the Medicare Shared Savings Program. UnityPoint Health-Fort Dodge was chosen to participate in the Pioneer model as Trinity Pioneer ACO. UnityPoint Health-Cedar Rapids is a member of the shared savings program. The MSSP ACO has reduced ER visits at St. Luke's Hospital by 68 percent.

University of Michigan Health System (Ann Arbor). University of Michigan's ACO includes more than 2,000 physicians from University of Michigan Medical School's Faculty Group Practice and IHA physician group in Ann Arbor. The Pioneer ACO achieved savings of 0.3 percent in its first year. In July 2013, after results from the Pioneers' first performance year were released, U-M Health System said the physician groups in the ACO plan to depart the Pioneer program and move to the Medicare Shared Savings Program.

VirtuaCare ACO (Marlton, N.J.). VirtuaCare ACO is the Medicare Shared Savings ACO of Virtua, a four-hospital system in southern New Jersey. Virtua joined the Medicare Shared Savings Program in January 2013. Stephen J. Kolesk, MD, Virtua's senior vice president of clinical integration, oversees the ACO.

Wellmont Integrated Network (Kingsport, Tenn.). Wellmont Integrated Network is the ACO of Wellmont Health System. The organization is made up of the primary care and specialty physicians of Wellmont Medical Associates and the Wellmont CVA Heart Institute, as well as the system's hospitals and other care facilities. It became a Medicare Shared Savings Program ACO in January 2013 and covers patients in northeast Tennessee and southwest Virginia.

Wilmington (N.C.) Health. Wilmington Health is a multispecialty group that provides care in more than 30 specialties. The group launched an ACO agreement with Blue Cross and Blue Shield of North Carolina in July 2012, which was the first insurer-provider ACO of its kind in the region. In 2013, a Wilmington Health subsidiary, Physicians Healthcare Collaborative, joined the Medicare Shared Savings Program.

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