100 accountable care organizations to know | 2015

Becker's Hospital Review is pleased to highlight a variety of Medicare and commercial payer ACOs, the majority of which are led by hospitals or health systems.

Accountable care organizations now cover approximately 23 million lives, according to Leavitt Partners. As the ACO movement continues to grow, this year marks some growing pains: Recent CMS data shows just one in four ACOs qualified for shared savings in 2014, 27 Medicare Shared Savings Program ACOs discreetly left the program and Pioneer ACOs have dwindled to 19.

Yet interest in ACOs and value-based care persists. In January, an additional 89 MSSP ACOs joined the ranks and 20 major health systems, payers and other stakeholders pledged to convert 75 percent of their business to value-based arrangements by 2020. In March, CMS launched its newest pilot, the Next Generation ACO. The estimated number of ACOs in public and private programs tops 740, according to Leavitt Partners, and if trends continue, ACOs have the potential to cover at least 75 million lives.

This is the fourth year Becker's Hospital Review has published its list of ACOs to know. For this year's list, ACOs were selected for inclusion based on a number of factors, including the number of providers in the network, earned shared savings and quality scores in Medicare's ACO programs, the lifespan of the ACO, whether it has arrangements with multiple payers, and if it recently struck new payer agreements or joined a new model. ACOs are presented in alphabetical order and are either listed by formal name of the ACO or, if the organization has several contracts, by name of the health system or provider group associated with those ACOs.

Accountable Care Coalition of Texas (Houston). Five provider groups comprise the Accountable Care Coalition of Texas, a Medicare Shared Savings Program participant that serves approximately 70,000 beneficiaries. The ACO formed in 2012, and in its first year it realized total savings of $9.4 million. Accountable Care Coalition of Texas was formed in partnership with Collaborative Health Systems, a management services organization that helps physician partners coordinate care.

Advocate Health Care (Downers Grove, Ill.). Advocate established its accountable care agreement, AdvocateCare, with Blue Cross Blue Shield of Illinois in 2010. In 2015, AdvocateCare was among the 30 ACOs with the largest physician participation, with 1,835 providers participating in value-based care agreements, according to SK&A Insights. The health system also joined the MSSP program in 2012, going by the name Advocate Physician Partners Accountable Care. More recently, Advocate established an ACO with UnitedHealthcare in September 2014.

Allina Health (Minneapolis). Allina Health was one of the 32 original Pioneer ACOs named in 2011. There are approximately 210 primary care providers participating in the ACO. Allina Health also joined forces with Bloomington, Minn.-based HealthPartners to form the Northwest Metro Alliance, a collaborative ACO seeking to achieve the triple aim quicker with pooled resources. The alliance covers approximately 300,000 beneficiaries.

Aledade (Bethesda, Md.). Launched by former National Coordinator for Health IT Farzad Mostashari, MD, Aledade partners with independent primary care physicians to help them form and operate ACOs. Aledade currently operates two MSSP ACOs — Aledade Primary Care ACO and Aledade Delaware ACO, both in Bethesda and both started Jan. 1 — and also has partnerships with practices and organizations in 11 states to help them launch and manage ACOs.

Alexian Brothers ACO (Arlington Heights, Ill.). Alexian Brothers launched its MSSP ACO Jan. 1, 2013. As of 2014, the ACO included more than 1,300 participating providers covering more than 40,000 beneficiaries. In May 2014, Alexian Brothers received approval to form Medicaid accountable care entities, the state-level version of ACOs. Then, in March of this year, the health system formed a new ACO with Blue Cross and Blue Shield of Illinois.

American Health Alliance ACO (Jacksonville, Fla.). In January 2013, 21 primary care providers from 12 practices formed American Health Alliance, an MSSP ACO covering more than 6,000 beneficiaries in north central Florida. Jay Panchal, MD, is the ACO's CEO and also sits on the board. The ACO was a founding member of the Florida Association of ACOs, an association seeking to align goals and physician incentives across the state.

Atlantic ACO (Morristown, N.J.). Atlantic Health System and Ridgewood, N.J.-based Valley Health System jointly formed Atlantic ACO. More than 1,800 physicians participate in Atlantic ACO, which is part of the MSSP program. Atlantic ACO covers nearly 74,000 beneficiaries. On June 1, 2014, Atlantic ACO launched an accountable care model with UnitedHealthcare, becoming the payer's first ACO in New Jersey.

Atrius Health (Newton, Mass.). Atrius Health is a nonprofit physician alliance comprised of four medical groups. The alliance was named a Pioneer ACO in 2011. In 2014, the ACO generated $2.8 million in savings.

Aurora Health Care (Milwaukee). In 2012, Aurora was selected to participate in the Medicare Shared Savings Program, which includes more than 10,000 Medicare beneficiaries in the Milwaukee area. Aurora also holds ACO agreements with two major payers. Its agreement with Aetna, called the Aurora Accountable Care Network, went into effect January 2013 and includes more than 1,500 physician participants. The system announced an accountable care agreement with Humana in January.

Banner Health Network (Mesa, Ariz.). A Pioneer ACO, Banner Health Network includes more than 2,600 Banner-affiliated physicians and 13 acute care hospitals. In performance year 2014, Banner Health Network generated $18.7 million in shared savings. Banner also has accountable care agreements with Aetna, launched in 2011, with Cigna, launched in 2012, and with UnitedHealthcare, launched in 2014.

Baylor Scott & White Quality Alliance (Dallas). With more than 3,800 primary care physicians participating, BSWQA is one of the largest ACO networks in the country. BSWQA formed accountable care agreements with Aetna in 2014 and with UnitedHealthcare in 2015. The network also joined the MSSP program as of Jan. 1, 2015. In March, the ACO received Level 2 ACO Accreditation Status from the National Committee for Quality Assurance, indicating the ACO has a high level of preparation to improve health care quality and efficiency while reducing costs.

Beacon Health Partners (Brewer, Maine). Beacon Health is a subsidiary of 11-hospital Eastern Maine Health System. The ACO was selected as a Pioneer ACO in 2011 and achieved shared savings of $2 million in its first performance year. Approximately 600 providers participate in the ACO. Beacon Health has grown from covering 9,000 patients to more than 100,000, making it one of the largest statewide ACOs in Maine.

Bellin-ThedaCare Healthcare Partners (Green Bay, Wis.). Another of the original Pioneer ACOs, Bellin-ThedaCare Healthcare Partners is a collaboration between Bellin Health and ThedaCare, two health systems located in eastern Wisconsin. In 2013, the ACO ranked No. 1 among the 23 Pioneer participants with a quality score of 94.11. The ACO achieved $3.2 million in savings that year. Last year, the ACO achieved $2.19 million.

Beth Israel Deaconess Care Organization (Westwood, Mass.). More than 2,100 physicians participate in the Beth Israel Deaconess Care Organization, one of the original 32 Pioneer ACOs from 2011. Four community hospitals affiliated with Beth Israel Deaconess, Cambridge Health Alliance and Anna Jacques Hospital also participate in the ACO. In 2014, BIDCO generated $9.85 million in savings.

Billings (Mont.) Clinic. Billings Clinic formed in 2013 as an ACO in the MSSP program. It was one of the first four ACOs in the country to receive accreditation as an ACO by the National Committee for Quality Assurance. Billings Clinic covers nearly 12,500 patients.

BJC HealthCare/BJC Collaborative (St. Louis). BJC ACO was chosen as one of 89 MSSP ACOs in July 2012 and was the first ACO to form in the St. Louis area. It covers more than 36,000 patients. Eleven hospitals, BJC Medical Group and BJC Home Services are among the providers participating in the ACO. Sandra Van Trease serves as its president.

Bon Secours Health System/Good Help ACO (Marriottsville, Md.). Good Help ACO was approved as an ACO in the Medicare Shared Savings Program beginning Jan. 1, 2013. In September of that year, Bon Secours Health System announced a new accountable care agreement with Aetna to use Aetna subsidiary Healthagen to coordinate care for 57,000 beneficiaries whose primary care physician participates in Good Help. Good Help ACO operates in Kentucky, Maryland, New York, South Carolina and Virginia.

Brown & Toland Physicians (San Francisco). Brown & Toland Physicians is a group of more than 1,500 independent physicians in the Bay Area. Almost 200 of those physicians participate in the group's ACO, which was selected as a Pioneer ACO in 2011. In 2013, the ACO generated $4.5 million in savings. The ACO cares for approximately 16,000 Medicare beneficiaries.

Carilion Clinic (Roanoke, Va.). Carilion Clinic is involved with two ACOs, a commercial one with Aetna as well as the Medicare Shared Savings Program. Carilion Clinic and Aetna formed an accountable care agreement in 2011. Carilion joined the MSSP in 2013 through an ACO called Doctors Connected.

CaroMont Health (Gastonia, N.C.). CMS selected CaroMont Health's ACO to participate in the Medicare Shared Savings Program in 2014. CaroMont Medical Group, a network of 44 physician practices in two states, partnered with Cigna to form an accountable care agreement in July 2013 that covers more than 3,000 patients. Participants include medical groups, a women's health center, acute care hospitals and hospice care.

Catholic Medical Partners (Buffalo, N.Y.). Catholic Medical Partners is a network of more than 900 physicians, making it the largest group of independent practicing physicians in Western New York. The network joined the MSSP as an ACO in 2012, and in 2013 the ACO achieved nearly $10 million in shared savings. Catholic Medical Partners has achieved Level 3 ACO Accreditation from the National Committee for Quality Assurance, the highest level of accreditation.

Catalyst Health Network (Plano, Texas). Though less than a year old — Catalyst Health Network launched in January 2015 — the physician-led network has already formed accountable care relationships with four of the key commercial payers, the first physician network in North Texas to do so. The first was with Blue Cross and Blue Shield of Texas, and UnitedHealthcare, Cigna and Aetna followed suit. Catalyst Health Network includes more than 175 providers.

Cedars-Sinai Accountable Care (Beverly Hills, Calif.). This ACO was selected in 2013 for participation in the Medicare Shared Savings Program. It includes Cedars-Sinai Medical Center, Cedars-Sinai Medical Care Foundation and Community Cedars-Sinai Health Associates Physicians. Thomas Priselac serves as president and chairman of the board.

Children's Hospital of Philadelphia. In 2013, CHOP became the first children's hospital in the country to receive accreditation as an ACO by the National Committee of Quality Assurance. The hospital achieved Level 2 ACO Accreditation by NCQA in March 2015, meaning the 535-bed children's hospital demonstrates efficiency, integration and high-quality care.

Cleveland Clinic. Cleveland Clinic's ACO is new to the ranks of MSSP ACOs, joining in 2015. The ACO is comprised of Cleveland Clinic-affiliated physicians as well as local independent physicians. The health system also has a collaborative care agreement with Cigna, which was initiated April 2013. With more than 2,800 participating physicians, Cleveland Clinic's agreement with Cigna is among the 30 biggest ACOs by physician count, according to SK&A Insights.

Crystal Run Healthcare (Middletown, N.Y.). More than 300 providers participate in the Crystal Run Healthcare ACO, one of the first 27 ACOs to participate in the MSSP. The ACO covers nearly 13,000 beneficiaries. Crystal Run Healthcare received Level 2 ACO Accreditation from the National Committee for Quality Assurance, the first in New York state and among the first six nationally to do so.

Dartmouth-Hitchcock (Lebanon, N.H.). In its first performance year as a Pioneer ACO, Dartmouth-Hitchcock received slightly more than $1 million in shared savings from Medicare. The ACO recently rebranded itself, changing its name to allwell and expanding to include three additional New Hampshire hospitals. The health system also partners with University of Vermont's Fletcher Allen Health Care in Burlington to create OneCare Vermont, an ACO comprised of all 14 of Vermont's hospitals, two New Hampshire hospitals and hundreds of physicians covering approximately 95,000 patients.

Dignity Health (San Francisco). In 2010, Dignity Health, then operating as Catholic Healthcare West, launched a pilot ACO program with University of California, San Francisco Medical Center and Hill Physicians Medical Group to coordinate care for more than 40,000 state employees. Then, in 2011 the organizations took on the care coordination of Blue Shield of California beneficiaries. Most recently, in 2014, Hill Physicians, Dignity and Blue Shield of California launched another ACO to cover 14,600 Blue Shield HMO members in San Joaquin County.

Duke Connected Care (Durham, N.C.). Duke Connected Care launched in January 2014 as part of the Medicare Shared Savings Program. Anchored within Duke University Health System, the ACO also includes physicians affiliated with the university, Lincoln Community Health Center also in Durham, North State Medical Center in Roxboro, N.C., and several physician practices. In 2015, Cigna announced a collaborative care initiative with Duke Connected Care covering approximately 10,000 individuals.

Emory Healthcare (Atlanta). Emory Healthcare formed its first accountable care agreement with Blue Cross and Blue Shield of Georgia in 2014. Emory is the largest health system in the state, and BCBSGa is the state's largest payer. In April of this year, Emory Healthcare announced an accountable care agreement with Aetna.

Essentia Health (Duluth, Minn.). Essentia Health joined Medicare's shared savings program in 2012, covering nearly 38,000 beneficiaries. In 2013, the health system was among the first six in the country to receive Level 2 ACO designation by the National Committee for Quality Assurance. In October 2013, the system achieved Level 3 designation, the highest level of accreditation.

Fairview Health Services (Minneapolis). A Pioneer ACO, Fairview Health Services manages the care of more than 13,000 Medicare beneficiaries. Approximately 275 providers from 46 Fairview Health Network clinics participate in the Pioneer ACO. Additionally, the system partnered with North Memorial Health Care in Robbinsdale, Minn., and payer Medica in 2013 to create a new ACO called Fairview and North Memorial Vantage with Medica.

FamilyCare (Portland). FamilyCare, founded in 1984, now serves more than 115,000 Medicare and Medicaid eligible residents of Oregon. FamilyCare was awarded Oregon's first Medicare ACO contract and through its partnership with the Oregon Health Plan, also acts as a coordinated care organization. FamilyCare's provider network includes a wide variety of healthcare professionals that are committed to an osteopathic approach, which extends to the organization's support of osteopathic medical education. With more than 3,700 physicians in the network, it is one of the largest ACOs by physician network size, according to an SK&A report.

Franciscan Alliance (Indianapolis, Ind.). Franciscan Alliance, a 14-hospital system, has four Medicare ACOs: one in the Pioneer program and three in the Medicare Shared Savings Program. Each is comprised of various Franciscan Alliance hospitals, affiliated physician groups and surgery centers. The MSSP ACOs are the Franciscan AHN ACO, Franciscan Select Health Network ACO and Franciscan Union ACO. The system also has commercial ACOs with Cigna and Aetna. Franciscan Alliance contracts now collectively cover more than 60,000 beneficiaries across Indiana and Illinois.

Forward Health Partners (Dallas-Fort Worth). This ACO was first announced in May as a partnership between five existing health systems: Children's HealthSM in Dallas, Cook Children's in Fort Worth, Methodist Health System in Dallas, Texas Health Resources in Arlington, and UT Southwestern Medical Center in Dallas. They comprise 42 hospitals, 72 outpatient facilities and more than 1,300 primary care physicians.

Hackensack (N.J.) Physician-Hospital Alliance. HackensackUMC, a nonprofit teaching and research hospital and the largest provider of inpatient and outpatient services in the state, is the anchor of the Hackensack Physician-Hospital Alliance ACO. The integrated Hacksensack system includes a cancer center, children's hospital, women's hospital and heart hospital. In April 2012, the organization became one of the first 27 organizations selected to participate in the Medicare Shared Savings Program. The ACO earned a total shared savings of $2.8 million for performance year 2014.

Health Connect Partners (Seattle). In December 2013, Health Connect Partners was selected as one of 123 new Medicare ACOs. The ACO is the result of a collaboration between Swedish Health System and Providence Health & Services-Washington with the aim of reducing medical expenses, improving the quality of care and increasing patient satisfaction. The Portland, Ore.-based Columbia Medical Group and Seattle-based Pacific Medical Centers are also partnered with the ACO, which boasts more than 3,000 participating physicians and serves more than 29,400 Medicare beneficiaries.

Health Share of Oregon (Portland, Ore.). Since September 2012, Health Share of Oregon has served its members in counties across the state. As a coordinated care organization, Health Share guarantees care to all members of the community and places a focus on wellness and preventative measures. The CCO is partnered with several health systems in the area, including but not limited to Oakland, Calif.-based Kaiser Permanente, Portland, Ore.-based Adventist Health and Providence Health & Services in Renton, Wash. Health Share of Oregon has nearly 18,000 medical, behavioral and dental care professionals and is one of the largest ACOs by physician network size, according to an SK&A report.

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 and was awarded Elite Status by the National Accountable Care Congress in July. 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. The group has commercial ACO agreements with DaVita, Monarch Healthcare and Anthem Blue Cross, a collaboration that boasted $4.7 million in savings for the first six months of 2013.

HealthCare Partners of Nevada (Las Vegas). HealthCare Partners of Nevada is a multispecialty independent physician organization with more than 300 primary care physicians and roughly 1,700 specialists. The ACO, which has approximately 100 primary care locations, participating medical care clinics and specialty affiliates through Las Vegas and surrounding towns, partnered with Humana in December 2014 to offer services to expand care for Medicare beneficiaries. The group was named to the Medicare Pioneer program in late 2011, but was one of nine to announce its exit from the program in July 2013.

HealthPartners (Bloomington, Minn.). Originally formed as a cooperative in 1957, HealthPartners has grown to become the largest consumer-governed nonprofit healthcare organization in the nation. In 2010, HealthPartners and Minneapolis-based Allina Health formed the Northwest Metro Alliance, which is a learning lab for ACOs. Currently, the Northwest Metro Alliance serves more than 1.5 million medical and dental health plan members nationwide with a network of more than 1,700 physicians and 22,500 care team members. HealthPartners was among the first to receive ACO accreditation from the National Committee for Quality Assurance in February 2013.

HealthTexas Provider Network (Dallas). The HealthTexas network was established in 1994 and is a multi-specialty medical group currently employing more than 2,300 physicians in the north Texas area, making it one of the largest ACOs by physician network size, according to an SK&A report. The network formed a partnership with Cigna in July 2013 and in fiscal year 2015 reported more than 2.2 million patient visits per year.

Heritage California ACO (Northbridge). Heritage California's ACO was one of the 32 original Pioneer participants. It is now partnered with affiliates that operate throughout eight counties and is one of the largest ACOs in the country by physician size, according to an SK&A report. In July 2013, the network partnered with Anthem Blue Cross and currently delivers care to more than 700,000 individuals through contracts with 2,300 primary care physicians and 30,000 specialists across over 100 hospitals.

Indiana University Health (Indianapolis). Through a partnership with the Indiana University School of Medicine in Bloomington, the Indiana University Health ACO aims to improve the health of the community through education, innovation and excellence in care. The ACO was selected to participate in the Medicare Shared Savings Program in 2012 and now serves more than 41,100 Medicare beneficiaries.

Integrated Health Network of Wisconsin (Brookfield). IHN was Wisconsin's first clinically integrated ACO. It launched in 2010 as Quality Health Solutions. IHN network members across the state include Agnesian HealthCare, Columbia St. Mary's, Froedtert Health, Hospital Sisters Health System, The Medical College of Wisconsin, Wheaton Franciscan Healthcare, SSM Health, and Ministry Health Care. The network includes 45 hospitals, more than 5,700 physicians, 500 clinic locations and 85  associated providers delivering patient care across 44 counties.

John Muir Health (Walnut Creek, Calif.). John Muir Health System was formed in 1997 and became part of the Medicare Shared Savings Program in 2012. In performance year 2014, the ACO earned shared savings of nearly $3.5 million and served more than 22,400 Medicare beneficiaries. John Muir Health began a collaboration in March with the UCSF Medical Center in San Francisco, called the Bay Area Accountable Care Network, which allows both organizations to remain independent but offer more convenient care to more members of the community across a larger area. Other partners include Health Net of California, the San Ramon Regional Medical Center and Stanford Children's Health.

Johns Hopkins Medicine Alliance for Patients (Glen Burnie, Md.). The Johns Hopkins Health System and Johns Hopkins University collaborated to start this ACO and joined the Medicare Shared Savings Program in January 2014. Partnerships include Johns Hopkins Community Physicians and the Johns Hopkins Medicine Hospitals, among other clinics and community practices. JMAP serves more than 37,200 Medicare beneficiaries.

Kelsey-Seybold Clinic (Houston). As the longest-standing ACO in Houston, Kelsey-Seybold's physicians and specialists have been providing coordinated care to patients for more than 60 years. It is also among the first organizations to receive ACO accreditation from the National Committee for Quality Assurance. Kelsey-Seybold's care delivery system spans more than 55 medical specialties throughout the greater Houston area and comprises advanced electronic medical record systems and a digital imaging and archiving infrastructure.

KentuckyOne Health Partners (Louisville, Ky.). Currently encompassing a network of more than 1,600 providers, 15 hospitals and nearly 3,000 physicians, KentuckyOne Health was accepted into the Medicare Shared Services Program in January 2013. The network's market area extends throughout Kentucky and regional areas in Indiana and Ohio. The ACO's earned shared savings for performance year 2014 was $2.1 million.

Lahey Clinical Performance ACO (Beverly, Mass.). Lahey Clinical Performance ACO joined the Medicare Shared Savings Program in January 2013 under its parent company Lahey Health. Lahey partners include CareWell Urgent Care, CVS/Caremark, Honoring Choices Massachusetts and St. Joseph's Hospital. The ACO earned $5.2 million in shared savings for performance year 2014, and the organization serves more than 36,000 Medicare beneficiaries.

LHS Health Network (Camden, N.J.). Comprising physician practices, hospitals and providers affiliated with the Lourdes Health System, the LHS Health Network ACO was formed in 2013 and accepted into the Medicare Shared Savings Program in December of that year. The organization also has commercial ACO contracts, partnering with Horizon Blue Cross Blue Shield of New Jersey in February 2014 and Aetna in June 2014.

MaineHealth (Portland). First formed in 2011, the MaineHealth ACO was accepted into the Medicare Shared Savings Program in July 2012 and now serves more than 49,400 Medicare beneficiaries. The ACO is made up of all MaineHealth members hospitals, the St. Mary's Regional Medical Center in Lewiston, Maine, and all members of the Community Physicians of Maine, which comprises more than 1,000 physicians. MaineHealth is also partnered with Anthem BlueCross BlueShield.

Memorial Hermann Health System (Houston). Since joining the Medicare Shared Savings Program in July 2012, Memorial Hermann ACO and the system's physician network launched partnerships with Aetna in April 2013 and Blue Cross Blue Shield of Texas in September 2013. CMS listed Memorial Hermann as the top MSSP ACO for generating the most shared savings in performance year one. The ACO earned $22.7 million in shared savings in 2014 and serves nearly 41,000 Medicare beneficiaries.

MemorialCare Medical Foundation (Long Beach, Calif.). Anthem Blue Cross and MemorialCare Medical Foundation, the physician division of MemorialCare Health System, announced their collaboration to form an ACO focused on providing treatment for Orange County, Calif., patients with chronic disease in April 2014.

Mercy Health (Chesterfield, Mo.). Mercy Health was selected to participate in the Medicare Shared Savings Program in January after launching a commercial ACO with Humana in April 2014. The network has more than 2,100 physicians, 700 outpatient facilities and 33 hospitals across Missouri, Arkansas, Kansas and Oklahoma serving more than 36,300 Medicare beneficiaries.

Methodist Patient-Centered ACO (Dallas). Methodist Health System formed this ACO, which includes more than 200 physicians and seven hospitals as well as outpatient clinics throughout northern Texas. It was selected to join the Medicare Shared Savings Program in July 2012. In the 2014 performance year, MPCACO earned $5.3 million in shared savings. The ACO covers more than 14,000 Medicare beneficiaries.

Michigan Pioneer ACO (Detroit). Michigan Pioneer ACO, affiliated with Detroit Medical Center, is one of 19 remaining ACOs participating in the Pioneer model. The ACO earned $5.9 million in shared savings in its second year of operation, when fewer than half of the other ACOs that launched in 2012 received earned any shared savings. Michigan Pioneer ACO coordinates care for approximately 13,000 patients.

MissionPoint Health Partners (Nashville, Tenn.). Saint Thomas Health developed MissionPoint Health Partners, which was chosen to participate as an ACO in the Medicare Shared Savings Program in January 2012. The ACO has 7,900 participating physicians, 250,000 members and has facilitated nearly 79,000 patient visits so far in 2015. MissionPoint also established a telemedicine program, Care-at-a-Distance, which is within the scope of the MSSP participation waiver and aims to make it easier for members to access care regardless of location.

Monarch Healthcare ACO (Irvine, Calif.). A part of the Pioneer ACO pilot project, Monarch Healthcare ACO now includes more than 2,300 independent, private-practice physicians who provide healthcare for approximately 176,000 Orange County residents. The Monarch Pioneer ACO saved 5.4 percent of forecasted medical costs following its launch, making it the second highest performer of the 23 pioneer organizations in 2013. For performance year 2014, the ACO earned $5.99 million in shared savings.

Montefiore ACO (New York City). Affiliated with Montefiore Medical Center, the Montefiore ACO was designated as the only Pioneer Model ACO in New York in 2011. In September 2012, Montefiore Medical Center also signed an ACO agreement with Empire BlueCross BlueShield. The ACO now serves more than 24,000 Medicare beneficiaries and earned a shared savings of $8.4 million in performance year 2014.

Mosaic Life Care (St. Joseph, Mo.). Mosaic Life Care's MSSP ACO includes Mosaic Life Care at St. Joseph Medical Center and Mosaic Life Care Clinic. In 2014, the ACO earned about $2 million in shared savings. Out of all the ACOs in the Medicare Shared Savings Program, Mosaic Life Care had the second highest overall quality score in 2014, clocking in at 95.11 percent.

Mount Auburn Cambridge (Mass.) Independent Practice Association. Partnered with Mount Auburn Hospital, the Mount Auburn Cambridge IPA is a Medicare Pioneer ACO. Approximately 500 physicians participate in the ACO, which reduced spending by 3.4 percent in its first year of operation, 2012. The ACO, which now serves more than 10,400 Medicare beneficiaries, earned shared savings of $3.9 million in performance year 2014.

National ACO (Beverly Hills, Calif.). Awarded participation in the Medicare Shared Savings Program in January 2013, National ACO is physician owned and operated and focused on providing participants and affiliates with the tools to improve care coordination. The ACO currently serves more than 5,500 Medicare beneficiaries.

National Rural ACO (Nevada City, Calif.). The National Rural ACO began participating in the Medicare Share Savings Program in 2014. It now consists of more than 30 hospitals across nine states. The NRACO was formed so rural organizations could overcome the high start-up costs and the MSSP's requirement for ACOs to cover at least 5,000 Medicare beneficiaries, which the initial nine hospitals that formed the organization could not have met on their own. The ACO now serves more than 14,000 Medicare beneficiaries.

NH Accountable Care Partners (Concord, N.H.). Dover, N.H.-based Wentworth-Douglass Hospital and Southern New Hampshire Health System in Nashua joined Concord (N.H.) Hospital and Manchester, N.H.-based Elliot Hospital to form this ACO in 2012 as part of the Medicare Shared Saving Program. Partnerships also include Foundation Medical Partners in Norwalk, Conn., and the Elliot Physicians Network. The organization covers more than 40,000 Medicare beneficiaries and includes more than 1,000 healthcare providers.

Noble Health Alliance (Fort Washington, Pa.). Composed of Philadelphia-based Aria Health, Springfield, Pa.-based Crozer-Keystone Health System, Philadelphia-based Einstein Healthcare Network and Abington (Pa.) Health, Noble Health Alliance ACO was formed in 2013. In August 2014, Noble partnered with Independence Blue Cross to serve as its sole benefits administrator. In 2015, Abington Health ended its ownership participation in the ACO but its physicians and facilities still remain within the provider network. The ACO now includes 15 hospitals, more than 2,200 physicians and dozens of outpatient facilities through southeastern Pennsylvania.

Northeast Medical Group (New Haven, Conn.). Northeast Medical Group, a physician group affiliated with Yale New Haven Health System, announced collaborative care agreement in May with Aetna. The group also formed an ACO with Cigna in fall 2012, covering approximately 18,000 people. In July 2014, the NEMG-Cigna partnership launched the Cigna Collaborative Care program, in which NEMG would monitor and coordinate all aspects of the medical care of its beneficiaries. In January, the organization was selected to participate in the Medicare Shared Savings Program.

Northwestern Medicine (Chicago). Northwestern Medicine, a collaboration between the four-hospital Northwestern Memorial HealthCare and Northwestern University's Feinberg School of Medicine, launched a collaborative care initiative in May for 5,600 Cigna plan members. This agreement nearly tripled its value-based care arrangements. Following its 2014 merger with Winfield, Ill.-based Cadence Health, Northwestern Medicine launched Cadence Health ACO earlier this year as part of the Medicare Shared Savings Program, which serves 18,000 beneficiaries.

Ochsner Accountable Care Network (New Orleans). The Ochsner Accountable Care Network connects seven hospitals, 38 health centers and more than 900 physicians across Louisiana with the aim to better coordinate care for more than 21,000 Medicare beneficiaries. The organization has been part of the Medicare Shared Savings Program since January 2013.

OhioHealth (Columbus). The 18-hospital OhioHealth system and The Medical Group of Ohio, together known as Health4, collaborated in 2011 to launch a 2,300-physician ACO with the Cleveland-based payer Medical Mutual. A year later, Health4 launched a second collaborative care initiative with Cigna for more than 17,000 beneficiaries. In 2014, it launched yet another accountable care agreement with Humana for 41,000 Medicare Advantage members.

OneCare Vermont (Colchester, Vt.). OneCare Vermont is the product of a collaboration between Dartmouth-Hitchcock in Lebanon, N.H., and the University of Vermont Medical Center in Burlington. In 2014, its second performance year, it coordinated care for about 55,000 of the state's Medicare beneficiaries as part of the Medicare Shared Savings Program. With 2,029 participating physicians, it is one of the country's largest ACOs by physician network size, according to healthcare research firm SK&A.

Orange Accountable Care of South Florida (Miami). Orange Accountable Care of South Florida joined the Medicare Shared Savings Program to better coordinate care in one of the country's most expensive Medicare markets. It started in the program in January 2014, and in its first performance year it served more than 7,700 Medicare beneficiaries.

Orlando (Fla.) Health. Orlando Health and its affiliated medical group Physician Associates formed the nonprofit health system's first ACO, Collaborative Care of Florida, in January 2013 as part of the Medicare Shared Savings Program. It was Florida's first hospital-based ACO. In 2014, Collaborative Care of Florida earned $2.4 million in shared savings in Track 1 of the model. Orlando Health has also launched commercial accountable care efforts with Cigna and Florida Blue.

OSF HealthCare System (Peoria, Ill.). OSF Healthcare System operates a Pioneer ACO that earned almost $4.9 million in shared savings in 2014 and ranked fifth for overall quality compared to other ACOs in the program. In 2013 the health system launched its first commercial accountable care agreement with Blue Cross Blue Shield of Illinois for 40,000 beneficiaries.

Palm Beach Accountable Care Organization (Palm Springs, Fla.). Palm Beach ACO, a Medicare Shared Savings Program organization with 110 primary care physicians and 95 specialists, was second only to one other MSSP ACO, Memorial Hermann, in 2014 for shared savings, earning $14.5 million. It started in the program in July 2012 and served almost 35,000 beneficiaries in 2014, its third performance year.

Park Nicollet Health Services (St. Louis Park, Minn.). Before becoming an ACO, Park Nicollet participated in the five-year Physician Group Practice Demonstration, CMS' first Medicare pay-for-performance program for physicians. As part of this program it achieved benchmark performance on all 32 quality measures. Then in 2011, Park Nicollet was named to the first cohort of 32 Pioneer ACOs. The most recent data available from 2014 shows Park Nicollet's Pioneer ACO serves more than 13,000 beneficiaries and earned $1.8 million in shared savings. The system additionally launched a commercial ACO in 2012 with nonprofit payer Medica.

Partners for Kids (Columbus, Ohio). Partners for Kids was first created in 1994 as a physician-hospital organization between Columbus-based Nationwide Children's Hospital and community-based pediatricians. It later launched a pediatric ACO for roughly 300,000 Medicaid-eligible children. In February, Pediatrics published a study revealing Partners for Kids had successfully slowed cost growth as compared to other Medicaid fee-for-service programs and managed care plans.

Partners HealthCare (Needham, Mass.). With 3,727 participating physicians, Partners HealthCare's Pioneer ACO was the largest ACOs in the country last year by physician network size, according to SK&A's 2014 report. As one of the original Pioneers, 2014 was its third performance year. It served nearly 70,000 patients and earned the second most shared savings in its program, receiving a total of $13.22 million.

The Physician Organization of Michigan ACO (Ann Arbor, Mich.). Known as POM ACO for short, the Physician Organization of Michigan ACO cares for more than 122,000 patients with 3,033 providers from 12 physician organizations as part of the Medicare Shared Savings Program, which it joined in January 2013. It is one of the country's largest ACOs. Last year, it earned the third most shared savings payments in the program, totaling $12.08 million.

ProHEALTH Accountable Care Medical Group (Lake Success, N.Y.). ProHEALTH Care Associates, one of the New York metropolitan area's largest integrated physician group practices, launched an ACO in the Medicare Shared Savings Program in 2012. The latest data available shows ProHEALTH was No. 1 in overall quality in the program with a score of 95.41 percent in 2014. It was also among the top five ACOs in the program in 2014 ranked by shared savings payments, earning $8.02 million. This January, ProHEALTH Care Associates announced plans to expand its coordinated care portfolio through a partnership with UnitedHealthcare that covers more than 35,000 employer-sponsored plan participants.

ProMedica (Sylvania, Ohio). ProMedica's ACO, ProMedica Physician Group, began in the Medicare Shared Savings Program in July 2012. ProMedica's nationally recognized patient-centered medical home care model was used as a basis for the organization. In the last performance year, ProMedica participated in Track 1 of the program and coordinated care for more than 16,800 Medicare beneficiaries.  

Renaissance Physician Organization (Houston). Renaissance Physician Organization is one of the largest independent physician associations in Houston, and with 2,135 participating physicians, its ACO is one of the largest in the country by physician network size, according to SK&A. It launched a collaborative care effort in 2012 with Cigna that includes 2,094 physicians.  

RGV ACO Health Providers (Donna, Texas). Rio Grande Valley ACO Health Providers joined the Medicare Shared Savings Program in April 2012. The ACO oversaw care coordination for more than 7,000 beneficiaries in Track 2 of the program in 2014, earning $7.5 million in shared savings payments. RGV ACO Health Providers physicians practice at 22 clinics in Donna and the surrounding area.

Robert Wood Johnson Partners (New Brunswick, N.J.). Robert Wood Johnson Partners is a clinically integrated network that is the product of a New Brunswick-based collaboration between Robert Wood Johnson University Health System and Rutgers University. Its network comprises more than 130 practices and 750 physicians. In January 2014, Robert Wood Johnson Partners launched as a Medicare Shared Savings Program ACO for about 8,500 beneficiaries.

Scripps Health (San Diego). Scripps Health first launched the Scripps Integrated Delivery Network, an ACO-like organization, with North American Medical Management in 2011. The IDN now includes more than 2,200 physicians. This January, the four-hospital system announced it was entering another collaborative care endeavor with Cigna for more than 10,000 beneficiaries. This partnership includes 750 primary care physicians and specialists.

SouthEast Michigan Accountable Care (Dearborn, Michigan). SEMAC is a physician-owned healthcare organization launched in July 2012 by a group of private-practice physicians. It participated in Track 1 of the Medicare Shared Savings Program in 2014 with nearly 13,000 assigned beneficiaries.

SSM ACO (St. Louis). SSM ACO, the collaborative care program for SSM Health, became a Medicare Shared Savings ACO in January 2014. This ACO oversees the care of approximately 22,500 beneficiaries in Missouri and Illinois. In March 2014, SSM Health also joined Missouri Anthem Blue Cross and Blue Shield's ACO-like patient-centered care program, Enhanced Personal Health Care. The nonprofit Catholic health system also joined Brookfield-based Integrated Health Network of Wisconsin's clinically integrated network earlier this year. As part of the agreement, SSM Health became part of IHN's ACO.

Steward Promise (Boston). Steward Promise is Steward Health Care Network's Pioneer ACO. With 2,500 primary care physicians and specialists, Steward Health Care Network is the second largest physician network in Massachusetts. Steward Promise was able to deliver savings in its first reporting year, 2012, and in 2014 generated $5.95 million in gross savings for CMS.  

Tenet Healthcare (Dallas). This for-profit system has dipped its toes in several accountable care waters around the country. The Michigan Pioneer ACO in Southfield, which is affiliated with Tenet's Detroit Medical Center, was the No. 4 Pioneer in shared savings in 2014, earning $9.82 million. Tenet's partnership with Humana, which includes 2,351 providers, is one of the largest ACOs in the country, according to SK&A. Tenet and Humana announced the launch in July 2014 of an ACO for Humana's Medicare Advantage beneficiaries in Atlanta. The system also has ACO contracts with Florida Blue and Cigna for its Florida-based ACO, Advantage Health Network; a contract with Blue Cross Blue Shield of Texas for a statewide Texas ACO; and a contract with Blue Shield of California.

Texas Health Resources (Arlington). Texas Health Resources and North Texas Specialty Physicians together in 2012 launched the Pioneer ACO Plus that left the program with nine other ACOs in 2013. However, the system continued in a number of accountable care efforts with commercial payers Cigna, Aetna, and Blue Cross Blue Shield of Texas. This year, Texas Health Resources announced it would combine ACO efforts with five other healthcare systems in the Dallas-Fort Worth area to form a joint ACO, named Forward Health Partners. Texas Health Resources also announced plans in June for its hospitals to become participants in Premier Patient Health Care's existing Medicare Shared Savings Program ACO.

Triad HealthCare Network (Greensboro, N.C.). The Triad HealthCare Network, a partnership between community physicians and Greensboro-based Cone Health System, joined the Medicare Shared Savings Program in July 2012. Triad HealthCare Network participated in Track 1 of the program in 2014, covering almost 36,000 assigned beneficiaries.

UnityPoint Health (Des Moines, Iowa). UnityPoint is affiliated with multiple ACOs. UnityPoint Health Partners has been a Medicare Shared Savings Program participant since July 2012. That ACO covers approximately 80,800 beneficiaries residing in Illinois, Iowa and Missouri. Its Fort Dodge, Iowa-based Trinity Pioneer ACO is one of the most rural Pioneer ACOs and has the smallest pool of beneficiaries with about 9,350 patient members. UnityPoint Health Partners is also working with the state of Iowa on the Iowa Medicaid Wellness ACO. It operates commercial ACOs with UnitedHealthcare and Wellmark Blue Cross and Blue Shield of Iowa and a value-based arrangement for self-insured employees.

University Hospitals (Cleveland). University Hospitals' value-based care portfolio includes three main ACOs: a pediatric ACO, an employee ACO and a Medicare Shared Savings Program ACO. Rainbow Care Connection, its pediatric ACO, was one of the first in the nation. Its employee ACO was established in 2010 for about 25,000 employees and dependents and it joined the MSSP in 2012, creating a program that now coordinates care for 46,100 Medicare beneficiaries. University Hospitals also has signed a number of commercial ACO contracts with payers such as Aetna, UnitedHealthcare and Cigna.

UW Health ACO (Madison, Wis.). UW Health launched its Medicare Shared Savings Program ACO in January 2013 as one of the state's first ACOs. The organization is a partnership between UW Health physicians, clinics, hospitals and medical school, and has approximately 28,600 assigned beneficiaries. It ranked No. 5 of all ACOs in the program in overall quality in 2014 with a score of 94.34 percent.

Valley Preferred (Allentown, Pa.). Valley Preferred is a provider-owned preferred provider organization aligned with the local Lehigh Valley Health Network that contracts with payers to provide businesses, organizations and individuals coverage and access to its network of hospitals and providers. Since 2013, it has operated a collaborative accountable care initiative with Cigna, and it announced a second initiative in early 2014 with Aetna. Its Aetna ACO has 3,533 participating physicians and its Cigna ACO has 1,590 participating physicians, making both among the largest ACOs in the country by physician members, according to SK&A.

Via Christi Health (Witchita, Kan.). Via Christi Health is affiliated with the Healthier You Alliance in Accountable Care that has been part of the Medicare Shared Savings Program since January 2014. In its first performance year, it had almost 20,000 Medicare beneficiaries. The ACO is comprised of about 660 providers from Via Christi and the surrounding community. This year, the Via Christi Healthier You Alliance in Accountable Care entered into an agreement with Blue Cross and Blue Shield of Kansas to further expand population health and cost reduction efforts.

VirtuaCare ACO (Marlton, N.J.). VirtuaCare ACO is the Medicare Shared Savings ACO of the four-hospital system Virtua. It joined the program in January 2013 as one of the region's first Medicare ACOs. The ACO now has more than 15,800 assigned beneficiaries. In 2014, VirtuaCare ACO joined six other organizations in a collaborative relationship with SilverScript Insurance Company to upgrade pharmacy care for patients with Medicare Part D coverage.  

Weill Cornell Physician Organization (New York City). Weill Cornell Physician Organization takes the title as New York City's first ACO between a physician organization and a health plan. In January 2012, Weill Cornell Physician Organization launched a collaborative accountable care initiative with Cigna that included 71 primary care physicians. The physician organization, which is comprised of Weill Cornell faculty who are attending physicians at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, also contracted with Aetna in September 2014. The ACO has 2,946 participating physicians, making it one of the country's 30 largest ACOs by physician network size, according to SK&A.

WellStar Health Network (Marietta, Ga.). WellStar Health System launched the WellStar Health Network ACO as part of the Medicare Shared Savings Program in July 2012. In 2014, it had approximately 38,000 assigned beneficiaries and earned $3.48 million in shared savings payments. Jim Budzinski serves as president of the ACO.

West Florida ACO (New Port Richey, Fla.). West Florida ACO was created by a group of independent physician practices. It joined the Medicare Shared Savings Program in April 2012 and has nearly 18,000 assigned beneficiaries. In its 2014 performance year, it earned $6.32 million in shared savings payments and hit a 91.23 overall quality score.

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