The Delaware Valley Accountable Care Organization and the Future of Clinician Payment

The DVACO leadership team has spent the past few weeks delivering substantial bonus checks to physicians who were participating in 2014, our first performance year, in which we received the 9th largest shared savings payout in the country for Medicare Shared Savings Program ACO’s. While this has been the cause of much celebration, I was reminded just today while at a regional CMS meeting that regardless of shared savings achievements, in our next contract cycle (2017-2019) the biggest changes in physician/clinician payment during most of our careers will go into effect and ACO’s are front and center. MACRA, MIPS, APMs- sounds like alphabet soup but these programs will begin to drive as much as 18% differentials in physician payment from Medicare – and as you know, the private payers tend to follow along shortly. In a nutshell, all of the current value-based programs (e.g. PQRS) will transition into clinicians being able to choose one of two tracks. The first, the Merit-based Incentive Payment System (MIPS) is a budget-neutral program in which performance in four domains (quality, care experience, cost efficient episodes of care, and Meaningful Use of Technology) will drive either payment reduction or increase. Doing nothing will likely result in an immediate 4% payment reduction in 2019, transitioning to -9%. The second option is to be a participant in an Alternative Payment Model (APM) like an ACO for a sizable portion of your Medicare business, or in a multipayor APM. In the APM track, a 5% annual bonus is paid, on top of any payments from shared savings. Use of an electronic medical record is mandatory in the...

Delivering Value

It is my great pleasure to be presenting to you the new website for the Delaware Valley ACO (DVACO).  As President and CEO of DVACO, I am passionate about improving population health outcomes, the care experience for patients and providers, and healthcare that is economically sustainable for our country. I came to DVACO to be able to do this work in my home community, with five outstanding health systems that are committed to community health improvement, a strong primary care focus, and a powerful size out of the gate. The DV in our name stands not only for our geography, but also our commitment to building regional care models that “Deliver Value” to all of our stakeholders.   This is a great moment in history where the business model of healthcare (i.e. how we get paid) can align with our founders’ century (plus) old missions of improving the health of the communities we serve. I’ve learned from 15 years of doing this work in care transformation, that it’s impossible to over-communicate; thus DVACO is redoubling its efforts to connect with you at every opportunity, to explain our current and future activities and how you can become engaged. Our revamped website reflects this commitment to communication to our multiple constituents in the communities we serve through our Member Health Systems and their affiliated physicians, who are all listed throughout our website. If you want to find out more about DVACO and/or you have specific questions, comments and concerns, please do not hesitate to contact us. 2015 will continue to bring breakneck-speed changes in healthcare, particularly here in the Philadelphia region, and...