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Montefiore Pioneer ACO Model Achieves Success In First Year

Results Show Improved Care Quality and Patient Outcomes with Significant Cost Savings

NEW YORK (July 17, 2013) – Montefiore Medical Center today announced it has improved the quality, outcomes and cost of care for Medicare patients as part of the Pioneer Accountable Care Organization (ACO) Model. Montefiore generated substantial savings to the Medicare program and achieved the highest financial performance among the 32 Pioneer ACOs, according to initial data reported by the Centers for Medicare and Medicaid Services (CMS) Innovation Center.

Savings were achieved through increased patient engagement, care coordination and preventative, patient-centered care provided wherever needed – in the hospital, in doctors’ offices, by phone and at home. Innovative nurse-driven interventions supported patient outcomes and experience. Through a unique collaboration with physicians in the community and across Montefiore’s healthcare system, Montefiore ensured clinical excellence at all points of care. The savings represent a seven percent reduction in the cost of care against the benchmark established for more than 23,000 patients attributed by the CMS Innovation Center to physicians in the Montefiore ACO.

“We are pleased to have been able to demonstrate to the nation that real change can happen with a vision, commitment and aligned financial incentives,” said Steven M. Safyer, M.D., president and chief executive officer, Montefiore Medical Center.  “Montefiore has been singularly focused on moving away from fragmented healthcare to more comprehensive care. Our success reflects our unique approach to healthcare and our strong partnerships with community physicians and other regional healthcare providers.”

More than 60 percent of the Medicare patients attributed to Montefiore’s ACO are under the care of private practice physicians in community offices. The remainder are under the care of Montefiore’s employed physicians. About 10 percent of patients with complex, chronic illness received intensive care management services from Montefiore. All ACO patients have access to Montefiore's innovative care coordination programs, if needed.   

Based on its success in the first year of the three-year Pioneer ACO Model, Montefiore will receive about $14 million of the savings it generated for Medicare. The funds will be both reinvested in Montefiore’s healthcare system and shared with participating physicians.

“Montefiore’s success is a testament to our more than 15 years of dedicated work in coordinating and managing care to improve patient health,” said Stephen Rosenthal, vice president, who runs Montefiore’s care management efforts. “Our experience identifying patients who need guidance in their care and developing programs to provide appropriate interventions created a solid foundation for our participation in the Pioneer ACO Model.”

Montefiore was among 32 institutions nationwide and the only one in New York State selected in 2011 to participate in the innovative Pioneer ACO Model. The program was designed and sponsored by CMS under provisions of the Patient Protection and Affordable Care Act to provide Medicare beneficiaries with high-quality care while reducing expenditures through better care coordination. To be successful in the first year, the participating organizations were required to report on 33 quality and patient satisfaction measures as well as lower the costs to the Medicare program. 

“Our first-year results indicate that actively engaging employed and community-based physicians in patients’ continuum of care can lead to better, more cost-effective care for our patients,” said Henry Chung, M.D., chief medical officer of Montefiore’s care management program and of the ACO. “In this system, everyone involved is accountable for guiding each patient toward the best treatments possible, with a goal of creating a healthier community.”

The Pioneer ACO Model is the most ambitious of the CMS Innovation Center’s programs and was designed for delivery systems like Montefiore that have extensive care coordination experience as well as experience with payment arrangements that include financial accountability and performance incentives. Montefiore has provided innovative services and interventions to help patients achieve optimal health for more than 15 years. It has developed an extensive infrastructure to provide medical and behavioral health management to more than 250,000 patients using advanced models of healthcare delivery in partnership with employed and community-based practitioners.