The National Rural ACO: Hundreds of Rural Health Systems, 50 ACOs, and the New World of Value-Based Payments
When we began this journey, our central premise was that every rural community should not have to figure out how to accomplish population healthcare on their own and that the population numbers had to reach enough scale to be affordable. We planned to develop the systems with our pilot group, test our scale up with second year enrollments and be ready to serve the market the third year. Our plan was to have 10 communities in year one, 30 communities in year two and 100 communities in year three. For every 10 communities we brought on board, we would need a project manager and a care coordination coach. We partnered with high-performing rural networks to engage the Executive Directors who lead the ACOs, and provided our own as well. We tested the scale up for 30 communities this year. Our plan worked and we are now ready to scale to the next level to support the 2016 applicants.
We have hired most of our senior staff and are currently refining our programs with the 2015 ACOs. Every member has their data, has hired Care Coordinators and has met with us monthly to work on redesigning the workflows at the clinic to optimize quality and reduce cost. We are constantly learning and sharing best practices across the country. The scale up of ACO Managers and Care Coordination coaches has been successful and can be replicated to meet the demands of our 2016 cohort.
The biggest change to our model in 2016 will be the addition of management and financial consultants to the team. These consultants will work hand in hand with the member’s CFO to ensure a smooth transition to value-based payments. Our 2016 members will get to choose from premier firms such as Alliant, BKD, Blue and Company, Coker, Eide Bailly, HFS Consultants and Quorum to attend steering committee meetings, review member financials monthly and make recommendations to improve performance. Alternatively, members can choose to work with our local network partners such as Hometown Health, Indiana Rural Health Association, Monida Health Network, New Mexico Rural Hospital Network, Northland Health Alliance, Southeast Texas Hospital System, Washington Critical Access Hospital Network, Washington Rural Health Collaborative, and the West Virginia Critical Access Hospital Network. These partnerships allow us to access local expertise while training our partners in these new programs.
Finally, we have selected four regional Vice Presidents who will serve as the Executive Directors of their ACOs and who will work with our member’s consultants to develop relationships with other payers in their state to implement similar gain-sharing arrangements for their Medicaid and commercial patients.
By leveraging our experience, scale and depth, we are the best opportunity for success in the transformation of your delivery system and preparation for the new world of value-based payments.
June 23, 2015 Accountable Care Organization, Medicare Shared Savings Plan, Payment Reform Read more >