Five organizations that serve Medicare recipients in Kansas have been granted Accountable Care Organization status by federal officials.
The designation is a product of the Affordable Care Act. The goal of Accountable Care Organizations is to find ways to reduce cost of health care while meeting certain quality standards set by Medicare.
The five groups are Kansas Primary Care Alliance, Oklahoma Health Initiatives, Physician Alliance of Kansas, Physician Collaborative of Kansas City and Via Christi Health Alliance in Accountable Care, according to a news release from the Department of Health and Human Services.
Once the organizations meet the quality standards and reduce costs for patient care, they will be eligible for incentive payments from Medicare.
“In the past, you would primarily focus on cost savings. The difference in this program is you have to look at quality first and achieve it before sharing in the cost savings,” said Ed Hett, medical director of new models of care for Via Christi Health, who will serve as the CEO for Via Christi’s new ACO.
Several other physicians will also serve in leadership roles at the new Via Christi ACO.
More than 630 physicians and midlevel providers – both Via Christi employees and independent practitioners – will be included in Via Christi’s ACO network, and more than 20,000 Medicare recipients are affiliated with those providers, said Monique Larrieu, senior administrator for strategic development at Via Christi.
The infrastructure is in place, and the program is to start Jan. 1, Larrieu said.
Via Christi will be sending information to Medicare recipients about the network. Patients can choose to opt out of sharing their data, Larrieu said.
“But it’s important for beneficiaries to participate,” she said. “That’s what gives us the ability to identify additional care needs.”
By becoming an ACO, Via Christi will have access to more Medicare claims data, Larrieu said. With that information, Via Christi will be able to look at the needs of the population and plan for things like better coordination of care and medication therapy.
Nationwide, more than 120 Accountable Care Organizations have been formed and are expected to cover more than 1.5 million Medicare beneficiaries.
Marlon Dauner, whose company Health Dimensions manages Physician Alliance of Kansas, says the ACO will have about 255 physicians and an estimated 16,000 Medicare recipients.
He said notification letters will be sent to patients soon.
“The objective is to not only improve care but to hopefully save dollars in the rendering of that care,” Dauner said. “We will look at various alternative sources of taking care of patients, like directing them to urgent-care centers and avoiding unnecessary utilization (of emergency rooms).”
Dauner said the alliance also hopes to better educate patients about their care and to encourage physicians to better communicate electronically to help bring down costs and better coordinate care.
Earlier this year, officials from Kansas Medical Center in Andover said the hospital was going to apply for ACO status, but Malik Idbeis, business development manager for the center, said it had withdrawn its application.
“After looking everything over, we decided it was in our best interest to take a step back and make sure that we were positioned correctly before pursuing an ACO,” Idbeis wrote in an e-mail.