South Shore Physician Hospital Organization Joins Boston Accountable Care Organization
August 18, 2017
South Shore Physician Hospital Organization has joined the Boston Accountable Care Organization (BACO).
Boston Accountable Care Organization is participating in a major restructuring of the MassHealth program to improve care and slow the rapid growth of MassHealth costs. BACO aims to better manage all aspects of health care to improve the health of the population served while operating more efficiently. BACO integrates the resources of its participants and their affiliated physicians to provide more effective, higher quality and less expensive patient care.
The Boston Accountable Care Organization will span several regions in the State and includes Boston Medical Center and the following health care organizations: Boston University Affiliated Physicians, Inc.; Boston University Family Medicine, Inc.; The Boston Health Care for the Homeless Program, Inc.; Child Health Foundation of Boston, Inc.; Codman Square Health Center, Inc.; Dorchester House Multi-Service Center, Inc.; Evans Medical Foundation, Inc.; Greater New Bedford Community Health Center, Inc.; Greater Roslindale Medical and Dental Center; Health First Family Care Center, Inc.; Manet Community Health Center, Inc.; Mattapan Community Health Center, Inc.; South Boston Community Health Center, Inc., South End Community Health Center, Inc.; South Shore Physician Hospital Organization, Inc.; Stanley Street Treatment and Resources, Inc.; Sturdy Memorial Hospital, Inc.; and Valley Health Partners, Inc./Holyoke Medical Center.
BACO program supports MassHealth's commitment to:
- Improve quality and member experience and integrate the full spectrum of care, including medical care, behavioral health and long term services and supports (LTSS)
- Provide clinical and community based support for populations with behavioral health and long term health care needs
- Shift incentives to hold providers accountable for quality and total cost of care for a population of patients
- Invest in primary care and community workforce development,
- Allow for innovative ways of addressing social determinants of health
- Expand access to substance misuse disorder treatment, including treatment for co-occurring disorders
BACO program is a major component in the state's five-year innovative 1115 Medicaid waiver, bringing in $1.8 billion in new federal investments to restructure the current MassHealth system. ACOs will receive more than $100 million in new investments throughout the remainder of 2017 to support the transition of health care providers providing value-based care. Funds will be used to:
- Enhance care coordination and management efforts through formal partnerships with certified Behavioral Health and LTSS Community organizations
- Improve electronic health records and ACO analytic capabilities
- Reduce avoidable inpatient and emergency department utilization
- Implement other key initiatives for ACOs to improve health outcomes and member experience under the new payment models
Member enrollment in ACOs will be based upon their relationship with their current primary care provider to ensure continuity of care. All ACO models support MassHealth's commitment to invest in community-based organizations, referred to as certified community partners for behavioral health and long term services and supports. These organizations will be announced by the end of August, once the procurement process has been completed.
South Shore PHO Selected As A Participating Organization In CMS Bundled Payment Program
South Shore PHO has recently been named a participating organization in the Federal Centers for Medicare and Medicaid Services (CMS) pilot program known as the Bundled Payments for Care Improvement (BPCI) Initiative. Under the BPCI initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. These models may lead to higher quality, more coordinated care at a lower cost to Medicare.