Why Advocate joined the "75% by 2020" task force: Q&A with CMO Dr. Lee Sacks

Advocate Health Care is already poised to reach the task force's goal — 75 percent of business from performance-based reimbursement — by the end of this year.

On Wednesday, a powerhouse of the biggest health systems in the country pledged to shift 75 percent of their business to value-based payment arrangements by 2020.

Health systems are one type of organization involved in this 28-member new task force — the group also includes payers such as Aetna, Blue Cross Blue Shield of Massachusetts and Blue Shield of California, along with policy groups like Dartmouth Institute for Health Policy and Clinical Practice and Leavitt Partners.

Downers Grove, Ill.-based Advocate Health Care is one of the provider organizations to join the task force.

Lee Sacks, MD, executive vice president and CMO of Advocate Health Care, said the timing of the announcement — and its proximity to HHS' new goals to move Medicare more toward value-based reimbursement — is coincidental. The task force has been in the works for a while now. Dr. Sacks attended the first meeting about it in June 2014.

"It's been a lot of work, and the thinking was we needed something fairly tangible and concrete before making a public announcement," he said. "I said this to a colleague a couple of hours ago: 'Did CMS get wind of this?' But, you know, it's all for the same cause."

Payers and providers in the task force have pledged to shift 75 percent of their businesses to value-based payment arrangements by 2020. (One of HHS' goals, announced this week, is to shift half of its Medicare provider payments to value-based models by 2018.)

Dr. Sacks says the task force's timeline will set organizations on a "path that won't put them out of business." It's very doable, he says.

This is especially true for Advocate. The health system is poised to reach the task force's goal — 75 percent of business from performance-based reimbursement — by the end of this year. Already, in 2014, approximately 63 percent of payments to Advocate providers came in via value-based contracts.

This was before Advocate launched its Medicaid accountable care entity, a three-year performance-based agreement under Illinois' Medicaid program. Advocate was one of the first five healthcare organizations in the Chicago area to receive the state's approval to launch the ACE. With that addition, Dr. Sacks expects 75 percent of the health system's business to be value-based by the end of 2015.

"We're almost there," he says. "We've been on this journey — this is our fifth year of working with commercial payers and shared savings [agreements]."

Advocate has positioned itself as a leader in population health management, striking one of the earliest and largest accountable care organizations with Blue Cross Blue Shield in 2010 and removing costs from the system through chronic disease management. The system also has an ACO in the Medicare Shared Savings Program, which hasn't stirred as much enthusiasm.

"I think it's not a big secret that a lot of delivery systems have been disappointed with the MSSP, whether it is the potential for savings, data lags or a lack of patient engagement," says Dr. Sacks. "It became clear for things that were frustrating us on the delivery system side, that unless we had a coalition that included payers, purchasers and delivery systems, we really weren't going to be able to solve the problem. It's about sitting down and saying, 'We all think the world needs to move to value, but how do we create a move to value that works for everybody?'"

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