Health Policy Commission Certifies 17 Health Care Organizations Through New ACO Program
First-in-the-Nation Program Aims to Improve Health and Lower Costs Through High-Quality, Coordinated Care
BOSTON – Thursday, January 4, 2018 – The Massachusetts Health Policy Commission (HPC) today announced that 17 health care organizations have met the requirements of its Accountable Care Organization (ACO) Certification program and are HPC-certified ACOs. The first round of ACO Certification is a significant milestone and makes Massachusetts the first state to implement state-wide, all-payer standards for care delivery.
The HPC’s ACO Certification Program is closely aligned with efforts by the Executive Office of Health and Human Services 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.
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 health care organizations from across the Commonwealth. Importantly, the HPC will certify all organizations participating in the MassHealth ACO program.
“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.”
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.
“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.”
Those organizations meeting the certification requirements are:
- Atrius Health, Inc.
- Baycare Health Partners, Inc., inclusive of Pioneer Valley Accountable Care, LLC; and Baystate Health Care Alliance, LLC
- Beth Israel Deaconess Physician Organization, LLC (Beth Israel Deaconess Care Organization)
- Boston Accountable Care Organization, Inc.
- Cambridge Public Health Commission D/B/A Cambridge Health Alliance
- Children’s Medical Center Corporation, inclusive of Children’s Hospital Integrated Care Organization, LLC; and Boston Children’s Health Accountable Care Organization (Boston Children’s Accountable Care Organization)
- Community Care Cooperative, Inc.
- Lahey Health System, Inc., inclusive of Lahey Clinical Performance Network, LLC; and Lahey Clinical Performance Accountable Care Organization, LLC
- The Mercy Hospital, Inc., inclusive of Mercy Health Accountable Care Organization, LLC; and Riverbend Medical Group, Inc.
- Partners HealthCare System, Inc., inclusive of Partners HealthCare Accountable Care Organization, LLC
- Reliant Medical Group, Inc., inclusive of Fallon 365 Care
- Signature Healthcare Corporation D/B/A Signature Healthcare
- Southcoast Health System, Inc., inclusive of Southcoast Accountable Care Organization, LLC; and Southcoast Health Network, LLC
- Steward Health Care Network, Inc., inclusive of Steward Integrated Care Network, Inc.; and Steward Medicaid Care Network, Inc.
- Wellforce, Inc., inclusive of Wellforce Care Plan, LLC; Lowell General Hospital/Lowell General Physician Hospital Organization; Circle Health Alliance, LLC; New England Quality Care Alliance, Inc.; and NEQCA Accountable Care, Inc.
In addition, the following organizations achieved provisional ACO Certification, which is for organizations without prior risk contracting experience that will begin operating as ACOs in the new MassHealth ACO program in 2018:
- Health Collaborative of the Berkshires, LLC
- Merrimack Valley Accountable Care Organization, LLC
The Massachusetts Health Policy Commission (HPC) is an independent state agency that develops policy to reduce health care cost growth and improve the quality of patient care. The HPC's mission is to advance a more transparent, accountable, and innovative health care system through its independent policy leadership and investment programs. The HPC’s goal is better health and better care – at a lower cost – across the Commonwealth.