July 09, 2012
John C. Lincoln Health Network has been notified by the Centers for Medicare and Medicaid Services (CMS) that its application to create an Accountable Care Organization (ACO) has been approved. John C. Lincoln's ACO began operations July 1, 2012.
An ACO is a group of health care providers who collaborate and agree to share responsibility for the total cost and quality of care for a designated group of fee-for-service Medicare patients over a period of time.
"CMS approval is difficult to achieve and requires three important components," said Nathan Anspach, senior vice president for the John C. Lincoln Physician Network and Accountable Care. "They require adequate primary care physician participation, an effective electronic health records system and documented experience in managed care."
Factors that led to CMS approval of the JCL ACO, he said, were:
- John C. Lincoln has developed the Valley's largest physician-led primary care group.
- More than a year ago, John C. Lincoln invested in the most sophisticated and technically advanced electronic health records system that will manage patient records at all JCL ACO participating primary care physicians offices and at both John C. Lincoln Hospitals.
- John C. Lincoln's personnel have decades of substantial experience in administering the medical care of large patient populations within the managed health care setting.
The JCL ACO is a key part of the Health Network's strategy to respond to the requirements of national health reform by creating a clinically integrated health care delivery system in partnership with Valley physicians.
Physicians and clinicians who participate in the JCL ACO will establish uniform patient care protocols for Medicare Part B and D patients to develop a medical home for each patient and to ensure delivery of the same high quality services across the Network.
The JCL ACO will incorporate the Health Network's primary care physician practices as well as partnerships with community primary care and subspecialist physicians in order to coordinate care for the Medicare fee-for-service patient populations that are assigned to the ACO. To maximize clinical integration of medical services, the JCL ACO will also partner with other institutions to incorporate health care components the Health Network does not currently have to clinically integrate.
This structure will expand the Health Network's recognized ability to efficiently provide health care services of the highest quality.
"John C. Lincoln has a strong reputation for quality and a history of collaboration with physicians and our community," said Rhonda Forsyth, president and CEO of the Health Network. "We believe the ACO aligns perfectly with our mission of providing the highest quality service for the people who depend on us."
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