More partnerships between doctors and hospitals strengthen coordinated care for Medicare beneficiaries
River Health ACO Approved as Medicare Accountable Care Organization
River Health Accountable Care Organization LLC has been selected as one of 123 new Accountable Care Organizations (ACOs) in Medicare, providing approximately 1.5 million more Medicare beneficiaries with access to high-quality, coordinated care across the United States, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.
River Health ACO, LLC, which includes PinnacleHealth System, Susquehanna Health, Family Practice Centers, Annville Family Medicine, Laurel Health Centers, and Susquehanna Community Health & Dental Center, was formed on April 15, 2013, to improve the cost, quality, access and patient experience for residents of central Pennsylvania. Effective January 1, 2014, River Health ACO will work with CMS to provide Medicare beneficiaries with high-quality care while reducing the rate of growth in Medicare expenditures. This will be accomplished by focusing more attention on health and wellness, providing additional services to patients with chronic disease conditions and providing better coordination of care.
“PinnacleHealth has achieved an important milestone in our journey to move our health care delivery system to an Accountable Care Organization (ACO) model. We are putting the patient at the center of care, helping them to navigate the healthcare system so they get the right care, from the right provider, at the right time and in the right place,” said Michael A. Young, president and CEO of PinnacleHealth System.
“By joining together our hospitals, doctors and other healthcare providers, we are creating a new system to provide high quality care to our patients. Patients benefit because our doctors and providers will build on the already strong connections we have with each other to help patients get the best care and improve their overall well-being,” says Steven P. Johnson, president & CEO of Susquehanna Health.
Medicare beneficiaries who fall under the River Health ACO will be notified with letters from their physicians. Doctors and Medicare coverage will not change. Patients can still see any doctors who are in Medicare, even those who are not members of the River Health ACO. However, by choosing physician participating in the River Health ACO, they will receive more coordinated care.
The physicians and staff of River Health ACO will work with Medicare beneficiaries who have complex chronic conditions, such as diabetes or congestive heart failure, to provide care management between medical visits. For patients who are well, wellness information and activities, such as screenings and immunizations, will help prevent or detect illness before it becomes serious.
About Accountable Care Organizations
Doctors, hospitals and health care providers establish Accountable Care Organizations (ACOs) in order to work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. Since passage of the Affordable Care Act, more than 360 (ACOs) have been established, serving over 5.3 million Americans with Medicare. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside of the ACO. ACOs share with Medicare any savings generated from lowering the growth in health care costs when they meet standards for high quality care.
The ACOs must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe, and timely. The Centers for Medicare & Medicaid Services (CMS) evaluates ACO quality performance using 33 quality measures on patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations.
The new ACOs include a diverse cross-section of healthcare providers across the country including providers delivering care in underserved areas. More than half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately one in five ACOs include community health centers, rural health clinics, and critical access hospitals that serve low-income and rural communities.
About PinnacleHealth System
is a pioneer not-for-profit healthcare system dedicated to improving the health and quality of life for the people of Central Pennsylvania since 1873. A proven leader in medical innovation, PinnacleHealth offers a wide range of services from primary care to the most complex surgeries and Magnet recognition for nursing excellence. The healthcare network includes four campuses (Community, West Shore, Harrisburg and Polyclinic). The West Shore Hospital will open in Hampden Township in 2014. The five-story hospital will include 108 beds with an emergency department, medical/surgical care, cardiology, orthopedics, chronic disease management, and private patient rooms. Medical services, including family practice, imaging, outpatient surgery and oncology are offered at multiple locations throughout the region. For a complete list of services, visit our website at www.pinnaclehealth.org
About Susquehanna Health
is a four-hospital integrated health system including Divine Providence Hospital, Muncy Valley Hospital, Soldiers + Sailors Memorial Hospital and Williamsport Regional Medical Center located in North Central Pennsylvania. Serving patients from an 11-county region, Susquehanna Health is a healthcare leader and has been recognized at the national and state levels for quality of care. Susquehanna Health offers a wide array of services that include cancer care, heart and vascular care/heart surgery, neurosciences including neurosurgery, orthopedics, urology, OB/GYN, gastrointestinal services, behavioral health, physical rehabilitation, home care, long term care, assisted living and paramedic/ambulance services.
About Family Practice Center, PC
Family Practice Center
, PC is a professional corporation comprised of 62 Family Practice, Internal Medicine and Internal Medicine-Pediatrics physicians and their 600 employees spread over 28 offices in 9 Central Pennsylvania counties. Our primary focus is providing comprehensive healthcare to our 210,000 patients while being active in the communities we serve. For 33 years our mission has been and will continue to be providing our patients and their families with quality and compassionate care with a focus on education, health maintenance and wellness in a comfortable location and time.
About Annville Family Medicine
Annville Family Medicine
is dedicated to the wellness of our community and patients, while providing personalized care with quality and integrity. Annville Family Medicine provides care for newborns through geriatric age patients. This includes well child care visits, well adult visits, complete physical exams, school physicals, work physicals, pre-op physicals, camp physicals and acute (sick) visits, etc. For more information, visit www.annvillefm.com
About Laurel Health Centers
Laurel Health Centers
offer family-based health services provided by family practitioners, general practitioners, and specialists in internal medicine, pediatrics, and nephrology. Primary healthcare services as well as special health services and educational programs are available through all six the Federally Qualified Health Centers.
About Susquehanna Community Health & Dental Center
Susquehanna Community Health & Dental Center’s mission is to extend God’s healing by providing inclusive, quality primary medical and dental care to all those who need it in the Lycoming County region. Susquehanna Community Health & Dental Center is part of the Lycoming County Health Improvement Coalition, a voluntary collaboration representing various sectors of the community, including religious organizations, schools and higher education, minority groups, municipal and county government, public health, health care, civic and community organizations, the private sector, and social welfare organizations.