Partners HealthCare has transitioned to a Medicare Shared Savings Program (MSSP) through the Centers for Medicare and Medicaid Services (CMS), from its previous Medicare ACO, the Next Generation Accountable Care model, without disruption to patient care. The Medicare Shared Savings Program (MSSP) is an alternative payment model that promotes accountability for a patient population, coordinates items and services for Medicare fee-for-service beneficiaries, and encourages investment in high quality and efficient services.
The MSSP Accountable Care Organization (ACO) allows Partners to extend care to roughly 10,000 additional patients, serving a total of approximately 125,000 Medicare patients; and adds nearly 2,000 additional Partners providers, totaling 9,300 providers supporting the Medicare population.
Pioneer ACO Model
Partners was one of the first Medicare Pioneer ACOs in the country, generating $36.7 million in cost savings for the federally funded program between 2012 and 2016. When CMS phased out the Pioneer ACO Model, Partners converted to the Next Generation ACO. In 2017, the first year that Partners HealthCare participated in the Next Generation ACO, the Partners system successfully provided quality care to approximately 88,000 Medicare patients, making it one of the largest Next Generation ACOs in the country.
Additionally, Partners has been approved to participate in the three-day skilled nursing facility (SNF) waiver, which waives the Medicare fee-for-service rule requiring a three-day inpatient stay prior to admission to an SNF, allowing Partners to continue this impactful program initiated under the Next Generation ACO. The new contract went into effect as of July 1, 2019.
Why It Matters
“This evolution of our Medicare ACO represents our ongoing commitment to value-based care, clinical care transformation and care management programs, including high-risk care management, behavioral health integration, and an advanced primary care strategy,” said Gregg Meyer, MD, MSc, Chief Clinical Officer for Partners HealthCare.