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2014 NC ACO Penetration (not including 2015 MSSP ACOs)

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Presentation on theme: "2014 NC ACO Penetration (not including 2015 MSSP ACOs)"— Presentation transcript:

1 2014 NC ACO Penetration (not including 2015 MSSP ACOs)

2 2015 NC MSSP ACOS  North Carolina has 18 Medicare Shared Savings Program ACOs  Accountable Care Coalition of Caldwell County, LLC (2012)  Accountable Care Coalition of Eastern NC (2012)  Cape Fear Valley Health System (2015)  Carolinas ACO, LLC (2014)  CaroMont Health (2014)  CHESS (Catawba Valley Medical Group, Inc., Cornerstone Health Care, P.A., High Point Regional Health System, Regional Physicians LLC, and Wake Forest University Health Sciences) (2015)  Coastal Carolina Quality Care, Inc. (2012)  Duke Connected Care (2014)  Carolina Medical Home Network Accountable Care Organization, LLC (FQHCs) (2015)  Mission Health Partners (2015)  Physicians Healthcare Collaborative (Wilmington Health) (2013)  Pinehurst Accountable Care Network (2015)  Triad Health Network, LLC (2012)  WakeMed Key Community Care (2014)  Coastal Plains Network, LLC (Vidant) (2015)  Bayview Physician Group (2014)  Central Virginia Accountable Care Collaborative, LLC (2014)  Pioneer Health Alliance (2015)

3 2015 NC ACOs with Commercial Contracts  At least 10 ACOs have contracts with commercial payers (about 5 overlap with MSSP*)  Accountable Care Alliance (Wilmington Health and NHRMC)-- BCBSNC*  Boice Willis Clinic (Rocky Mount)--Cigna  Cape Fear Valley Health System--BCBSNC*  Carolina Advanced Health--BCBSNC  Carolinas Health System--Aetna  Cornerstone Health Care, PA--all commercial payers*  Duke Connect Care--Cigna  Key Physicians--Cigna*  WakeMed Key Community Care--BCBSNC*  Novant Health--Cigna

4 CMS Funding Opportunities Fall 2014  Transforming Clinical Practice Initiative (TCPI)— innovative model to support clinicians in achieving large-scale health care transformation; $840 million over 4 yrs/150,000 clinicians  Provider Transformation Networks (PTN)—peer-based learning; 3 NC applicants: AHEC, CCNC, CHESS  Support and Alignment Networks (SAN)—workforce development; 1 NC applicant: NCMS Foundation

5 CMS Funding Opportunities Fall 2014  ACO Investment Model (AIM)—upfront funding for MSSP ACOs serving rural and underserved populations  NCMS Foundation Rural ACO Initiative Community Practitioner Program Participants Others RFP for services sent to select vendors

6 Recent Announcements  Secretary Burwell announced that HHS would move:announced  30% of its total spending in Medicare to value-based payments by 2016; and  50% by 2018 through models like ACOs and bundled payments.  The Health Care Transformation Task Force, a coalition of health care systems, payers and associations announced the formation of, a collaboration intended to bring to bear private-sector experience and influence in moving the market toward value-based care. moveannounced  Move 75% of their revenue into value-based payments by 2020.  Anthem, the third largest insurer in the US by membership, revealed that it had nearly $40 billion in value-based contracts and agreements with nearly 120 ACOs around the country. Anthem’s announcement is similar to earlier declarations from other insurers including United and Cigna. (Leavitt Partners)revealedUnitedCigna

7 Resources  Toward Accountable Care Consortium and Initiative (TAC):  National Association of ACOs (NAACOS):  CMS:  Transforming Clinical Practice Initiative: Practices/ Practices/  ACO Investment Model: Model/ Model/

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