Atrius Health is pleased to announce that the Massachusetts Health Policy Commission (HPC) has certified it as an Accountable Care Organization (ACO) in its new, first-in-the-nation program. The HPC’s first round of ACO Certification includes 17 HPC-certified ACOs and is a significant milestone for Massachusetts, making it the first state to implement state-wide, all-payer standards for care delivery.
At Atrius Health, we have a long history of working with the Centers for Medicare and Medicaid Services (CMS) and commercial payers to provide patients with outstanding quality care at lower costs. As one of the 32 organizations originally selected as a CMS Pioneer ACO, Atrius Health ranked first nationally in quality scores after completing the fifth and final year of the model in 2016. Currently as a CMS Next Generation ACO and a MassHealth ACO partner with Tufts Health Plan, we continue to innovate care delivery through coordinated, preventive services and by moving the site of care to lower-cost ambulatory, home and virtual settings.
“For decades, Atrius Health has delivered superlative care with accountability for cost, quality and patient experience to keep the communities we serve healthier,” said Dr. Steven Strongwater, President and CEO of Atrius Health. “We are delighted to have been selected for this first-of-its kind program, and look forward to our continued collaboration with the Health Policy Commission in an effort to reduce the total cost of care in Massachusetts and better serve patients across the Commonwealth.”
The HPC’s ACO Certification Program is closely aligned with efforts by the Executive Office of Health and Human Services (HHS) and the Office of MassHealth to improve health and reduce health care cost growth in the Commonwealth through ACOs. The goal is a health care delivery system that delivers coordinated, patient-centered health care that accounts for patients’ behavioral, social, and medical needs.
“The ACO program represents a significant change in the way MassHealth contracts with health care organizations throughout the state,” said Massachusetts Secretary for Health and Human Services, Marylou Sudders. “The goal of the ACO program is to improve the care coordination and health outcomes for 850,000 MassHealth members and we are pleased they all met the thorough certification standards.”
For the first year of the program, the HPC defined a set of criteria on which to assess ACOs for certification against that goal. However, unlike other state or federal programs, the HPC’s certification program evaluates ACOs on an all-payer basis, including for their Medicaid, Medicare, and commercially-insured patient populations.
The HPC-certified ACOs include a diverse cross-section of 17 health care organizations from across the Commonwealth. Importantly, the HPC will certify all organizations participating in the MassHealth ACO program.
“The ACO Certification Program will bring new transparency and information to the public regarding how ACOs are structured and operating today,” said David Seltz, HPC Executive Director. “The HPC expects to analyze the information received and identify best practices and areas of improvement for payers, policy-makers, researchers, providers, and consumers.”
In order to be evaluated for certification, organizations were required to provide information for 15 standards, including patient-centered governance, performance improvement strategy, experience in quality-based risk contracts, population health management programs, and ability to coordinate cross-continuum care. Full certification is effective for two years and organizations with provisional certification must apply for full certification within one year.