February 12, 2018

UAB creates an Accountable Care Organization to boost quality and lower costs for Medicare patients

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UAB partners with other health care providers to start an Accountable Care Organization to deliver better health care at a lower cost to Medicare patients.

medicare couple docACOs are groups of health care providers who give coordinated, high-quality care to their Medicare patients. The University of Alabama at Birmingham Health System has established an Accountable Care Organization to partner with other health care providers to improve quality and care for Medicare patients in Alabama.

The ACO members are UAB Hospital, the University of Alabama Health Services Foundation, Medical West Hospital, and two Federally Qualified Health Centers, Christ Health Center and Cahaba Health Center. The Centers for Medicare and Medicaid Services authorized the ACO to begin serving patients in the beginning of 2018.

ACOs are groups of health care providers, such as doctors, hospitals and other providers, who come together voluntarily to give coordinated, high-quality care to their Medicare patients. UAB’s ACO manages more than 16,000 covered lives.

“The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors,” said Will Ferniany, Ph.D., CEO of the UAB Health System. “When managed properly, an ACO can succeed in delivering high-quality care while spending health care dollars more wisely and efficiently, helping to lower overall health care costs.”

“When managed properly, an ACO can succeed in delivering high-quality care while spending health care dollars more wisely and efficiently, helping to lower overall health care costs.”

The ACO participates in the CMS Medicare Shared Savings Program, which is designed to achieve better health for individuals and better population health and to lower the growth of health care spending. The program tracks prior year benchmarks for cost and quality. Cost savings are shared between the partner organizations and Medicare.

The ACO is administered by a separate organization called the Alabama Physician Network, LLC, established by UAB in 2017, to spearhead initiatives between UAB Medicine and community physicians as part of a clinically integrated network. The APN is managed by its own board of directors, led by physicians and professional health care administrators. The board is chaired by Tony Jones, M.D., UAB’s chief physician executive. Thirteen of its 17 members are physicians.

According to Jones, the keys to a successful ACO include:

  • Establishing mechanisms to monitor and control utilization, quality and cost
  • Investment in the necessary infrastructure to realize the benefits
  • Establishing goals and protocols that support evidence-based best practices.
  • Effective monitoring of quality of care, cost and utilization compared to standards through shared information
  • Investing in human and technology infrastructure needed to achieve the goals and the ability to aggregate shared data
Other initiatives of an ACO include improving quality measures such as conducting and completing breast, colon and other cancer screenings, better monitoring of diabetes care, and encouraging immunizations. The ACO also helps drive UAB’s academic missions by partnering with community physicians across Alabama.