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Montefiore ACO to Participate as Medicare Pioneer Accountable Care Organization

New Model Designed to Offer Better Care to Beneficiaries through Partnership with Medicare

New York City, New York (December 19, 2011) - The Montefiore ACO has been selected to participate as a Pioneer Accountable Care Organization (ACO), a transformative new initiative sponsored by the Centers for Medicare & Medicaid Innovation (CMMI). Montefiore's ACO is one of only 32 organizations in the nation, as well as the only one in New York State, to operate under this new model of providing Medicare beneficiaries with higher quality care, while reducing expenditures through enhanced care coordination.  

Since 1996, Montefiore, the University Hospital and academic medical center for Albert Einstein College of Medicine, has been a pioneer in developing advanced models of healthcare delivery and innovative payment methodologies. Montefiore has extensive experience providing comprehensive care management services under contractual relationships with health plans.  

CMMI estimates that approximately 23,000 traditional Medicare beneficiaries in the Bronx will be eligible for care coordination services from the Montefiore ACO because of their current or past use of one or more of Montefiore's 2,400 employed and community-based physicians.

"As an academic medical center with a truly integrated delivery system and unique focus on the community, Montefiore has been practicing accountable care long before the acronym ACO was developed," said Steven M. Safyer, MD, President and CEO Montefiore Medical Center. "Being a Pioneer ACO is consistent with our vision of transforming health care delivery by aligning incentives toward performance rather than fee-for-service transactions, resulting in more patient-centered, coordinated care."   

If Montefiore meets quality standards based on patient outcomes, patient experience and care coordination, as well as reducing costs over the three-year period currently contemplated for the Pioneer program, it will share a percentage of the savings.   

"At Montefiore, we have embarked on a path that has allowed us to provide excellent healthcare to an extremely challenged community," said Joel A. Perlman, Executive Vice President of Finance at Montefiore Medical Center and President of the ACO. "We have formed a highly integrated team of physicians, nurses, social workers, mental health professionals and other caregivers that has enabled us to track and maintain the health of our patients, whether they get care in our ambulatory care centers, our hospitals and community doctors' offices and even in their own homes."

"By focusing on preventing health problems rather than just treating them, Montefiore is a pioneering and proactive care provider," said Stephen Rosenthal, President and COO of the Care Management Company (CMO) of Montefiore Medical Center and Chief Operating Officer of the ACO. "With the start of the Pioneer ACO program in January, we will identify the Medicare "fee for service" beneficiaries most in need of care coordination and implement interventions immediately."

The Pioneer ACO is one of a number of initiatives developed by the new Innovation Center to test new models of health care delivery and payment. The Montefiore ACO was chosen in a competitive process in which it demonstrated its experience in coordinating care for patients across multiple care settings.

Unlike a managed care plan, Medicare beneficiaries in a Pioneer ACO will maintain the ability to see any doctor or healthcare provider, continue to receive the full benefits associated with traditional Medicare and be eligible to receive the ACO's care coordination and management services.

"These Pioneer ACOs represent our nation's leaders in health systems innovation, providing highly coordinated care for patients at lower costs," said Marilyn Tavenner, Acting Administrator of CMS. "Montefiore's Pioneer ACO has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them."