Value-Based Care News

Accountable Care Organizations Make News in Massachusetts

By Ryan Mcaskill

$60 million awarded to Mass hospitals to improve participation in accountable care organizations.

- Over the last few weeks, accountable care organizations have been front and center for a couple announcements out of Massachusetts.

The first big piece of news is that Health Policy Commission (HPC) has awarded 28 community hospitals $60 million in the most recent round of state funding. This was developed through the state’s health care cost containment law, which was passed in 2012. This year, the funds were distributed to help enhance access to behavioral health services and ready hospitals to participate in accountable care rather than fee-for-services.

Hospitals eligible under the CHART Investment Program receive funding to make transformational changes with the goal of adopting new systems including electronic health records and alternative payment methods, while enhancing patient safety. Every hospital and organization will receive at least $900,000.

“These awards represent a commitment by the HPC to reduce the cost of health care by focusing on supporting community hospitals in delivering care to the most complex – and often highest cost – patients,” HPC Chairman Dr. Stuart Altman, said in a release. “Consistent with the HPC’s policy priorities, this unprecedented scale of coordinated investment will support hospitals and their community partners in meeting real challenges facing the Commonwealth’s most vulnerable residents.”

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  • The largest individual investment this round, $3.9 million, goes to Holyoke Medical Center. The money will be used to support behavioral health care and the creation of a care navigation team to ensure the appropriate treatment for behavioral health patients.

    The largest collective grant, $8 million, goes to Southcoast Health. The investment will support initiative to reduce total medical expenditures through population health management approaches in a variety of chronic and acute disease management services, including behavioral health.

    Request for information

    The other big piece of accountable care news that came from Massachusetts recently is a Request of Information (RFI) request that was submitted on September 19, 2014 and amended on October 24, 2014.

    Submitted by MassHealth, the RFI is to solicit information from a broad spectrum of interested parties regarding a proposed MassHealth initiative to use accountable care organizations to increase the coordination and delivery of health care services for MassHealth members.

    The goal is to evaluate options for ACO development and build on its existing Alternative Payment Methodologies, including the Primary Care Payment Reform Initiative (PCPRI).

    Ultimately, MassHealth, hopes to improve the delivery, coordination and quality of health care. The organization also seeks to utilize payment methods that are alternatives for fee-for-service and that reward ACOs for delivering high-quality, cost effective care and reducing the rate of growth in expenditures for health care in Massachusetts.

    This is part of a broader efforts by MassHealth to transform the health care system in Massachusetts by restructuring the delivery of care and changing reimbursement for health care services.