Franciscan Alliance selected to participate in Medicare Accountable Care Organization

Health system is first in Indiana and among few nationally to participate in program

INDIANAPOLIS – Franciscan Alliance today (Dec. 19) announced it has been selected to participate in the Pioneer Accountable Care Organization (ACO) model, a transformative new initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center.

The Franciscan Alliance ACO is the first and only Pioneer ACO in Indiana and among the first in the country to partner with Medicare as an ACO. Initially, this partnership includes Franciscan St. Francis Health (which operates hospitals in Indianapolis, Beech Grove and Mooresville) and other affiliated hospitals and physician groups.

“More than 22,000 Medicare patients in Indianapolis and central Indiana will be served initially by our ACO,” said Jennifer Westfall, Franciscan Alliance ACO executive director. “From an industry perspective, the ACO model encourages organizations such as hospitals, physician practices, and other healthcare providers to collaborate closely, thus bringing down the overall costs of medical care.”

Franciscan Alliance will work with CMS to provide area Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures, through improved care coordination.

The Pioneer ACO Model is designed to encourage the development of patient-centered, team-based care, with health-care providers delivering coordinated, high-quality care for their patients. Franciscan Alliance ACO was chosen specifically by Medicare for the Pioneer Program.

“These Pioneer ACOs represent our nation’s leaders in health systems innovation, providing highly coordinated care for patients at lower costs,” said Marilyn Tavenner, Acting Administrator of CMS. “Franciscan Alliance has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them.”

Under the Pioneer ACO Model, CMS will provide incentives for participating health care providers who form an organization to coordinate care for patients. Providers who band together through this model will be required to meet quality standards based upon, among other measures, patient outcomes and care coordination among the provider team.

CMS will use robust quality measures and other criteria to reward ACOs for providing beneficiaries with a positive patient experience and better health outcomes, while also rewarding Franciscan Alliance for reducing growth in Medicare expenditures for the same patient population.

Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. The Pioneer ACO Model is not a health plan or managed care plan. Under the Pioneer ACO Model, beneficiaries seeing doctors participating in an ACO will maintain the ability to see any doctor or healthcare provider, as well as the full benefits associated with traditional Medicare, but with the added benefit of a more coordinated care experience.

Today’s announcement was the culmination of a competitive selection process that began in May 2011 with the national release of a Request for Applications from CMS. Franciscan Alliance was selected based on its demonstrated capabilities to offer high quality, coordinated care.

With 14 hospitals in Indiana and Illinois, Franciscan Alliance provides care for more than 2.9 million outpatient visits and more than 100,000 inpatient discharges every year with the most effective medical treatments and innovative technology.

Franciscan Alliance, one of the largest Catholic health care systems in the Midwest, employs 18,200 co-workers and has more than 3,300 affiliated physicians – both primary care and specialists – serving nearly 4 million people in the system’s service areas.

To learn more about Franciscan Alliance and Franciscan St. Francis Health, go to www.franciscanalliance.org and www.stfrancishospitals.org.

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About the Pioneer ACO The Pioneer ACO Model is one of a number of initiatives developed by the new Innovation Center. The Innovation Center was created by the Affordable Care Act to test new models of health care delivery and payment. For more information about the Pioneer ACO Model, visit the Pioneer ACO website at www.innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/pioneer-aco/. The Pioneer ACO Model is one of several initiatives underway at CMS designed to encourage the formation of ACOs. For more information, visit www.cms.gov/aco. For more information about the Innovation Center, visit innovations.cms.gov.