A Monday morning announcement from the U.S. Department of Health and Human Services could mean good news for Medicare patients throughout Iowa.
A number of eastern Iowa hospitals have signed contracts with the Centers for Medicare and Medicaid Services, or CMS, to provide higher quality care for Medicare patients.
The 2010 Affordable Care Act created a shared savings program through Medicare. If health care providers commit to provide higher-quality and better-coordinated care for Medicare patients, then, ideally, the patients will be overall healthier in the long run, there will be less duplication of services and the federal government will save money.
Hundreds of health care providers nationwide have opted to become part of what's called an Accountable Care Organization, or ACO, through Medicare. By committing to provide higher-quality care to Medicare patients, the providers will get a cut of the federal savings.
The DHSS announced Monday morning federal savings from this initiative could total up to $940 million over four years.
It also announced 89 new ACOs on board with the program, four of which are in Iowa. That brings the total number of ACOs nationwide to 154, which covers more than 2.4 million Medicare patients throughout the US.
The four Iowa groups that have formed ACOs are Genesis Health System in the Quad Cities (Genesis ACO, LLC), the Iowa Health System in Des Moines (Iowa Health Accountable Care, LC), Mercy Medical Center in Des Moines (Mercy ACO, LLC), and the University of Iowa Hospitals and Clinics in Iowa City (University of Iowa Affiliated Health Providers, LC).
David Brandon is the president and CEO of The Finley Hospital in Dubuque, which isn't currently part of a Medicare ACO but plans to create one in the future. Finley is a part of Iowa Health System, however, which has several hospitals in one of the ACOs announced Monday morning.
Brandon said Medicare's shared savings program incentivizes both the health care providers and the patients, "making it easier for the patient to maneuver through the system, making it much more coordinated in the care that we're providing to them, so the end result is, we hope, this increases quality of care at the same time as lowering the cost of care."
He said prior systems of care were more fragmented and that Medicare patients won't lose their ability to choose their physician.
"It doesn't change the access for the patient, and that's important," Brandon said. "They don't lose their ability to go to the physician that they have chosen."
He called ACOs the health care system of the future.
"This is really the first time that I can recall where all of the providers of care are working together, collectively, to make sure that the patient is getting appropriate care at the right time," he said. "I think that's where this differentiates so greatly from the models that we've used in the past."
He estimates 40 to 45 percent of the patients at eastern Iowa hospitals are Medicare beneficiaries, so thousands of area folks could see an increase in the quality of their care.
The Medicare shared savings program has only been in effect since January, so many more health care providers expect to get on board in coming years.
Iowa health care providers participating in an ACO include the University of Iowa Hospitals and Clinics, Mercy Medical Center in Cedar Rapids and St. Luke's Hospital in Cedar Rapids, among others outside of eastern Iowa.
To read the DHSS's Monday morning announcement, click HERE.
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