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Why the ACO model is working for Montefiore Medical Center

by Diana Bradley, Staff Writer | August 02, 2013
Among the 32 facilities across the U.S. included in the Pioneer Accountable Care Organization (ACO) model, New York's Montefiore Medical Center achieved the highest financial performance, according to a recent report from the Centers for Medicare and Medicaid Services (CMS) Innovation Center.

Further to saving Medicare $23 million, Bronx-based Montefiore improved the quality, outcomes, and cost of care for Medicare patients in the first year of the three-year ACO model. Based on its success, Montefiore will receive approximately $14 million of the savings it generated for Medicare. The savings represent a seven percent reduction in the cost of care against the benchmark established for more than 23,000 patients attributed by the CMS Innovation Center to physicians in the Montefiore ACO.

"These funds will be reinvested in Montefiore's health care system and shared with participating physicians in the community," said Dr. Henry Chung, chief medical officer of Montefiore's care management program and of the ACO. "That reinvestment will allow the Center to continue to provide patients with high-quality, cost-effective care and continue to build out its accountable care organization."

The secret to success

The key to Montefiore's success in accountable care is focusing on the patient, according to Chung. It's all about being armed with the proper tools and experience to identify at-risk ACO beneficiaries and provide the right care management services targeted to each patient's unique needs across the continuum of care, he explained.

"Our extensive care coordination infrastructure can assist patients whether they are being treated in the hospital, in the community, at a post-discharge care facility or even at home," Chung told DOTmed News. "In addition, strong alignment with our employed and community providers allows us to quickly identify at-risk patients and offer them appropriate interventions."

However, Chung acknowledges this solution may not work for everyone.

"There is no single magic bullet to address the needs of every beneficiary," he said. "We must meet them where they are in life and health and offer myriad tools to address their needs. Our success is due to Montefiore's long-term investment in building an integrated care delivery system, which includes strong partnerships in the community with a range of health care providers and a well-developed care management infrastructure."

For example, EMR technology and experience in identifying beneficiaries' total universe of needs — including medical, mental health, and social — allow for implementation of appropriate interventions.

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