Florida ACO Reports a $22 Million Savings

A Florida accountable care organization (ACO) is reporting $22 million in savings during its first year, with a shared savings of $11 million. Of the 114 ACOs that originally participated in the Medicare Shared Savings Program, the Palm Beach ACO was 1 of 29 that exceeded savings projections. When the shared savings was totaled for all 29 ACOs, and distributed among the ACO participants, each member physician’s share came to about $63,000, according to a Viewpoint article that appeared in the May issue of the Journal of the American Medical Association.

According to a news release issued by the American Academy of Family Physicians (AAFP), more than 75 percent of physicians in the ACO are solo practitioners. There are a total of 240 physicians in the network, and 120 are in primary care. Physicians are free to join and can leave at any time. The organization has no formal hospital affiliation.

Physicians who join the Palm Beach ACO are not required to make practice changes. If a practice decides to make adjustments such as extending office hours, answering phones after hours or hiring additional staff, it does so at its own discretion.

"It is physician-owned and physician-run," said Lenny Sukienik, MD, the group's medical director in the AAFP release. "Every physician has skin in the game."

ACO representatives visit each physician’s office at least 3 times per month and a medical director—either Sukienik or family physician Theresa Goebel, MD—visits each quarter. Additional networking meetings are scheduled frequently at member physicians' offices.

Sukienik emphasized that decisions about patient care rests with the physician in concert with the patient, and not an insurance company or hospital.

"Physicians need to run ACOs," Sukienik said. "If you have a hospital running an ACO, it won't work."

The big difference that distinguishes the Palm Beach ACO from traditional physician practices is its use of data. Medicare provides the ACO with detailed patient billing data. Physicians can analyze that data for their entire patient population or for each individual patient to pinpoint all care received, including emergency department visits, subspecialist visits, or visits outside of the practice.

"The data (analysis) is so important, much more important than we thought," Sukienik said. "It makes a huge difference in how we treat patients. The physician thinks about it in a different way. Medicare patients can go anywhere. A patient could travel to New York and have three COPD (chronic obstructive pulmonary disease) visits and you'd have no way of knowing that."

Source:

After One Year, Physician-run ACO Scores Big Savings Bonus. http://www.aafp.org/news/practice-professional-issues/20140811palmbeachaco.html