New in Health Affairs: Performance of a Medicare ACO, and the Shift to VBP

There are currently over 500 Accountable Care Organizations (ACOs) serving over 9 million patients in Medicare alone.

As Nicholas Stine, MD, Dave A. Chokshi, MD, MSc, Janine Knudsen, MD, Megan Cunningham, JD, and Ross Wilson, MD, describe in “Performance of a Medicare Accountable Care Organization at the Largest Safety Net Health System in the United States,” recently published on Health Affairs, ACOs are a key driver of the national shift from fee for service to value-based care, and a potential key to sustainable long-term financing of health care in the United States.

NYC Health + Hospitals formed an ACO in 2012, and it has been quite successful, according to the authors, all of whom are staff of NYC Health + Hospitals. In its first four performance years it reduced costs by 4-12% annually compared to benchmark while continually improving quality. Additionally, it is the only ACO in New York to achieve shared savings in all four Medicare Shared Savings Program performance years.

Through this experience, the authors have gleaned valuable insights for the development of broader value-based payment (VBP) strategy for NYC Health + Hospitals and its community partners – the importance of data to orient strategy; levering clinical leadership and a mission-driven culture; and effective data synthesis leading to actionable opportunities for the front lines. And the need is accelerating; with rapid payment transformation and regulatory uncertainty affecting all health systems, the authors note that safety-net systems like NYC Health + Hospitals face particularly difficult financial circumstances, and their future may be dependent on their ability to adapt.

Fortunately, they believe there are strengths inherent to safety net systems that may be leveraged more effectively under VBP. Read the full report in Health Affairs for their lessons learned on their ACO journey at NYC Health + Hospitals, which is the country’s largest safety net health system.

For more on NYC Health + Hospitals’ Accountable Care Organization’s shared savings, read the recent press release.