DO-led ACO selected to be among nation’s first for new Medicare program
An osteopathic physician-led accountable care organization (ACO) has been selected as the only one in New York City and one of 27 across the country to participate in Medicare’s new Shared Savings Program. To qualify for this program, which rewards ACOs for delivering high-quality care under targeted savings benchmarks, the Chinese Community Accountable Care Organization had to demonstrate the ability to meet many criteria related to care coordination, data sharing and quality measurement, says the ACO’s president, Lisa Eng, DO.
Established in concept by the Affordable Care Act, ACOs are voluntary networks of physicians intended to improve health care quality and reduce health system costs by enhancing care coordination. Made up of more than 200 physicians, including more than 100 in primary care, the Chinese Community ACO serves approximately 12,000 Medicare beneficiaries, a large proportion of whom are Chinese immigrants, in the boroughs of Queens, Manhattan and Brooklyn.
“We are going to do what the Affordable Care Act asks us to do as an ACO—to take care of patients well while trying to reduce redundancy in over-ordering of tests,” says Dr. Eng, an obstetrician and gynecologist. “We’re going to share data and know more about our patients as a result. We’ll be able to obtain some epidemiological information.”
ACOs that take part in the Shared Savings Program, which began April 1, must report on 33 quality measures covering patient and caregiver experiences, care coordination, preventive medicine screenings and the management of patients at risk for several chronic diseases. Chinese individuals, according to Dr. Eng, are especially susceptible to diabetes mellitus and often don’t undergo recommended cancer screenings, such as colonoscopies, mammograms and pap smears.
“Liver cancer is rampant among the Chinese,” says Dr. Eng, who is also the president of the Association of Chinese American Physicians. “In addition, Chinese immigrants frequently feel a sense of isolation and suffer from depression. These are things that Chinese doctors are attuned to. We know what Chinese immigrants eat, so when we talk to them about food and diabetes, we have an edge from a cultural standpoint.”
The Chinese Community ACO is still implementing its data collection and other protocols for the Shared Savings Program. “The data will be submitted to CMS at the end of the year,” Dr. Eng says.
Altogether, the 27 Shared Savings Program ACOs serve an estimated 375,000 Medicare beneficiaries in 18 states. “We are encouraged by this strong start and confident that by the end of this year, we will have a robust program in place benefitting millions of seniors and people with disabilities across the country,” said CMS Acting Administrator Marilyn Tavenner in a statement.
CMS is reviewing more than 150 applications from ACOs seeking to enter the Shared Savings Program on July 1.