Affirmant OK’d for new Medicare accountable care organization

Affirmant Health Partners in Kalamazoo has been approved as one of six new Medicare accountable care organizations in Michigan and will join 15 other ACOs already taking care of more than 300,000 seniors.Affirmant’s new contracting entity, called The Federation ACO, will be assigned 71,000 traditional Medicare patients over the next several months in the five markets — Kalamazoo, Saginaw, Jackson, Lansing and St. Joseph — in which its participating five partner systems and 1,200 doctors, including 400 primary care and 800 specialty physicians, are located.

The other ACOs newly approved to operate in Michigan are:

  • Aledade Independent ACO LLC under executive Travis Broome
  • McLaren High Performance Network LLC under executive Gary Wentzloff
  • Trillium Health LLC under executive Marie Jannausch-Hooper
  • UOP ACO LLC under executive Anthony Vespa
  • OSF Healthcare System, which also operates in Illinois, under executive Kevin Schoeplein

Under incentives provided by the Affordable Care Act, hospitals and doctors have been working together the past five years to reduce costs and improve quality for nearly 13 million Medicare patients under various alternative payment models.Over the last three years, Michigan’s 15 ACOs — which range from accepting full financial risk to sharing savings — have performed better overall than national averages, said the Centers for Medicare and Medicaid Services, the federal agency that oversees the Medicare ACO programs.

Medicare pays ACOs based on the services provided to patients and the level of care they provide. Accountable care organizations are also judged based on various quality measurements. ACOs with high quality scores and low costs share savings with Medicare. Those that produce poorer outcomes and higher costs may lose money.

Overall, Affirmant is the state’s largest clinically integrated network with seven health system partners that operate 33 hospitals and more than 6,000 physicians. Located across the Michigan’s Lower Peninsula, Affirmant features:

  • Bronson Healthcare, Kalamazoo
  • Covenant HealthCare, Saginaw
  • Henry Ford Allegiance Health, Jackson
  • Lakeland Health, St. Joseph
  • MidMichigan Health, Midland
  • Spectrum Health, Grand Rapids
  • Detroit-based Henry Ford Health System, which isnow part of Allegiance.

Because Henry Ford and MidMichigan already operate ACOs, the Federation ACO includes only Bronson, Covenant, Henry Ford Allegiance, Lakeland and Sparrow. Early last year, Henry Ford formed a Next Generation-type ACO, one of three available ACO models.”Affirmant is all about creating a healthy Michigan at an affordable cost,” said Bill Mayer, M.D., CEO of Affirmant. “Everything we do is help make that happen. Obviously, Medicare represents an enormous portion of health care in Michigan. We are honored and thrilled to work with the Medicare program to deliver better value to patients.”

Mayer said Affirmant is dedicated to add value to its member health systems by helping them create and deliver better clinical and financial data to physicians and hospitals; enable physicians to improve their practices and share information; and partner with health plans and payers that include Medicare.

But Mayer said Affirmant is not interested in direct contracting with employers.

“Our view is that health plans are critical partners in meeting the needs of payers and employers,” he said. “We are not looking to compete or duplicate what health plans do. “We work with patients and providers to try and delivery better quality at a lower cost.”

Mayer said the Federation ACO hasn’t contracted yet with post-acute care providers such as home health agencies, nursing homes or rehabilitation providers. “We are looking at post-acute care as an important focus area for improving quality and reducing costs,” he said. “We plan on addressing this in several ways” that include using data to help doctors and hospitals track patient care.

CMS announced a variety of other health system and physician organization participants in four of Medicare’s alternative payment models. They include ACOs, comprehensive end-stage renal disease care model and the comprehensive primary care plus model. There are approximately 700 ACOs participating, including more than 100 new ACOs, and 2,893 primary care practices involved with the programs.

“These models demonstrate CMS’s commitment to partner with providers to improve care for patients,” Patrick Conway, acting principal deputy administrator and director of the CMS Innovation Center, said in a statement.

“My mother and over 12 million other Medicare beneficiaries are now cared for by doctors and other clinicians in payment models that focus on better health outcomes and coordinated, high quality care.”

Other Next Generation Michigan ACOs include Michigan Pioneer ACO LLC, owned by Detroit Medical Center; the Henry Ford Physician ACO; and Trinity Health ACO.

Other ACOs include Dearborn-based Oakwood ACO LLCUnited Outstanding Physician’s Southeast Michigan Accountable Care, also based in Dearborn; The Accountable Care Organization Ltd., based in Farmington Hills; Genesys Physician Hospital OrganizationAccountable Healthcare Alliance P.C.St. John Providence Partners in Care and Physician Organization of Michigan ACO.

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