By Staff Reports
(Honolulu) – The Queen’s Health Systems today announced it has launched a first-in-Hawaii program designed to provide Medicare patients with improved access to primary and specialty care medical providers.
The program is called the Medicare Shared Savings Program Accountable Care Organization or MSSP ACO.
“The goal is to provide coordinated quality care in a manner that ensures beneficiaries receive the right care at the right time, while avoiding unnecessary duplication of services,”said Dr. Whitney Limm, Chief Physician Executive of The Queen’s Health Systems.
17,600 Medicare beneficiaries across the State will be cared for by over 200 primary care physicians and 400 specialists in the ACO, according to Limm.
ACOs are groups comprised of doctors, hospitals, and other care providers who have chosen to work together to coordinate care for patients they serve. Unlike HMOs, the program is not a type of insurance with a narrow network and restrictive rules. ACOs reward providers who do a good job caring for their traditional, fee-for-service Medicare patients.
In the ACO model, the sponsoring healthcare system invests in training, and technology-driven solutions that have been proven to help patients live happier, healthier lives. The ACO supports care management services that help primary care providers care for their complex and struggling patients, reducing frustration and improving health outcomes for patients and their caregivers.
“I have gotten great support from the care management team. It’s led to operating more efficiently, closing care gaps, and increasing our reimbursements,” said primary care physician Gerald Soon, MD. He is already one of hundreds of community and employed providers who have joined the MSSP ACO.
Effective July 1, 2019:At their first visit of the year, Medicare patients with a primary care provider in the Queens MSSP ACO will be informed of their provider’s involvement and will automatically be eligible for enhanced services. Examples of enhanced services to the patient of an ACO provider:
- access to free or low-cost diabetes education sessions
- special provider-led support groups for family caregivers of complex and frail elderly patients
Currently, there are over 1,000 ACOs across the country covering some 33 million lives. About half of those ACOs are also Medicare Shared-Savings Programs. Recent reports find ACO models are consistently showing strong quality outcomes for attributed patients. A 2017 report found providers in ACOs outperformed all Medicare providers on most clinical and patient experience-related quality measures.
Supporting an MSSP ACO makes sense for Queens. The MSSP ACO’s mission mirrors Queen’s mission and solidifies QHS as a health care leader in the state; emphasizing the Queen’s commitment to patient satisfaction and high-quality connected care for the community; and ensuring system sustainability into the future. As the healthcare landscape changes in the country, it meets the system’s commitment to maintain access to quality healthcare for Medicare patients by ensuring independent and Health System employed primary care physicians across the Islands are supported.
Queen’s MSSP ACO Executive Director Amy Feeley-Austin believes the implementation of the ACO program will have a widespread positive impact on Medicare Patients across the state. “We want to be a driving force in improving health care delivery. It’s not just about data points or savings to Medicare driven by reduced avoidable utilization. It’s about helping patients, their families, and all the people of Hawaii live well, remain independent, and improve their quality of life.”
To learn more about the QCIPN and the MSSP ACO call 808-691-7220 or email QCIPN@queens.org.