ANN ARBOR, Mich. — For the fourth year in a row, an initiative by Michigan physician organizations has improved care for Medicare participants across the state, while making a positive difference in the cost of that care.
According to data from the federal Centers for Medicare and Medicaid Services, members of the statewide Physician Organization of Michigan Accountable Care Organization, LLC (POM ACO) achieved high results for both quality of care and cost of care in 2016.
The approximately 6,000 physicians and providers who make up POM ACO together saved the traditional Medicare system $8 million in predicted costs in 2016, and achieved 94.1 percent of all quality measures set out by the government in the Medicare Shared Savings Program.
Together, POM ACO members are primarily responsible for the care of more than 95,000 Michigan residents who have traditional Medicare coverage.
“POM ACO is one of very few ACOs to achieve both savings and high quality for four years running,” says Timothy Peterson, M.D., POM ACO executive and a physician at Michigan Medicine, the University of Michigan academic medical center. “Given that we are also one of the largest and most established ACOs, we are especially proud of all that our member providers and their colleagues have achieved on behalf of Michiganders who rely on Medicare.”
POM ACO is one of 480 accountable care organizations across America launched under the Medicare Shared Savings Program through the Affordable Care Act.
While the savings achieved by POM ACO in 2016 were just shy of the amount needed to share part of the savings with member physician groups, Peterson notes that members have already invested in improvements in 2017 that will continue to move the needle on care quality and cost.
“Our involvement in the ACO program has led us to develop a care team approach in many of our clinics,” says POM ACO executive medical director Martha M. Walsh, M.D., who is the Chief Quality and Population Health Officer of the IHA physician organization based in Ann Arbor. “This includes ancillary staff that all help to improve the experience for our patients including care managers, behavioral health social workers, and pharmacists. This improves patient access to these services improving both the quality of care and decreasing the total cost of care for our patients.
In 2016 and 2017, POM ACO members have worked to help Michiganders avoid unnecessary emergency room visits and preventable hospitalizations.
They’ve increased the number of Michiganders who take advantage of Medicare benefits that can set the stage for better health care, including Welcome to Medicare clinic visits for newly enrolled patients, and Annual Wellness Visits, disease screening and preventive care for ongoing patients.
A lot of cost and quality opportunities lie in the transition between hospitals and nursing homes or other skilled nursing facilities, and in the number of days spent in both types of facilities. POM ACO is focusing on these transitions and stays by partnering with the facilities where its participating beneficiaries tend to receive care.
Each provider receives detailed information about his or her performance on quality measures, and practices and groups share best practices and innovations with one another. This allows them to coordinate the care that Medicare beneficiaries receive from different primary care and specialty providers, and to prevent health issues and repeat hospitalizations.
“The ability to collaborate across the State of Michigan on clinical integration and data analytics has been invaluable. This partnership has given our practices access to best practice sharing across the best-quality health systems across Michigan,” says Kim Speese, RHIA, CPHQ, MBA, the executive director of the Wexford/Crawford physician hospital organization, which has taken part in POM ACO since its inception. “Sharing of ideas and hearing about other health system’s experiences with specific activities has allowed us to streamline some of our approaches to improving care in Northern Michigan. We have been able to take the data POM ACO provides and drill down to practice-specific levels; this has allowed us to assist our practices in defining specific improvement plans for this population.”
POM ACO is preparing for calendar year 2018 and expects to add more providers to its ranks.
A history of improving care & bending the cost curve
Launched in 2013 as a joint venture of U-M and six physician groups around the Lower Peninsula of the state, POM ACO complemented the Pioneer accountable care organization that U-M’s faculty physicians already belonged to at the time.
By moving U-M physicians and other providers into POM ACO in 2014, U-M continued its longstanding commitment to new models of care. That commitment began in 2005, with participation in the CMS Physician Group Practice demonstration project that led to the creation of the now-national ACO model.
This is the eleventh year in a row in which U-M physicians have saved the Medicare system money by coordinating and improving care as part of innovative federal programs.
For more about U-M’s participation in these efforts, see http://www.uofmhealth.org/pophealth.
Learn more about POM ACO and its participating clinical locations at www.pom-aco.com