News

Recent news and press releases of the Delaware Valley ACO

Delaware Valley ACO, Humana Expand Value Based Care Partnership

As partnership enters its second year, results show improved health measures

PHILADELPHIA & LOUISVILLE, Ky. – December 14, 2015 – Delaware Valley ACO (DVACO), one of the largest Medicare shared savings programs in the U.S., and Humana (NYSE:HUM), a leading health and well-being company, announced favorable results stemming from their year-old partnership. Since 2014, Humana members cared for through the value-based agreement with DVACO have experienced a ten percent increase in medication therapy adherence and a four percent increase in disease management program participation.

In addition, the relationship expanded to include 22 additional physician practices last month, including Abington Health (now part of Jefferson Health), making the value-based health care model now available to 8,200 Humana Medicare Advantage members in the Delaware Valley.

Value-based health care is a new and growing health care model that emphasizes primary care, quality and a more coordinated care experience for patients. The approach, also called accountable care, features tools and information to help primary care physicians and health systems better manage the overall health of the people they care for.

“Seeing gains in drug adherence and disease management participation is important,” explained Eric Bohannon, Vice President of Humana Medicare Products in Pennsylvania. “These early indicators show that value-based care is doing what it’s supposed to: shift our health care system toward a more proactive, coordinated approach.”

The partnership gives Humana members in-network access to DVACO’s integrated health systems, featuring Jefferson Health, Main Line Health, Holy Redeemer Health System, and Magee Rehabilitation Hospital. For 2016, DVACO features 667 primary care physicians in five counties.

“At DVACO, we are strongly committed to forming partnerships that will expand our ability to provide coordinated, high quality health care across the care continuum to the communities we serve,” said Katherine Schneider, M.D., M.Phil., FAAFP, president and CEO at Delaware Valley ACO. “We are delighted to build on our 2014 success with Humana. They have brought expertise and resources to the partnership that have allowed us to accelerate the shift to value-based care for the Medicare Advantage population for our participating hospitals and physicians.”

The value-based health care model reflects a shift away from the current episodic health care model to a value-based model that emphasizes quality and better patient care experiences. The accountable care approach aligns DVACO’s and Humana’s complementary population health capabilities, including chronic disease management, wellness programs and data analytics to help predict and avert serious health events.

“The growing trend toward value-based care here in Southeast Pennsylvania is an important shift in the way our health care system works,” said Bohannon. “We now have the tools to help doctors spend more time with their patients and create long-term health in addition to treating sickness.”

The expanded Humana-DVACO agreement includes value-based incentives tied to performance improvement and quality outcomes, emphasizing standard measures defined by the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS), including breast cancer screening, colorectal screening, comprehensive diabetes care, and high-risk medications.

Humana has a 30-year accountable care relationship history. The company has 1.6 million individual Medicare Advantage members and 200,000 commercial members today that are cared for by approximately 44,000 primary care physicians, in more than 900 value-based relationships across 43 states and Puerto Rico..

About Delaware Valley ACO
The Delaware Valley Accountable Care Organization (DVACO) is a limited liability company that is owned by Main Line Health, Jefferson Health, Holy Redeemer Health System, Doylestown Health, and Magee Rehabilitation Hospital. DVACO’s purpose is to enhance the quality of health care and reduce the growth rate of health care costs by acting as a convener, accelerator, and provider of the foundation needed to assist its participating members to transition from fee for service model, a business model focused on volume to a model focused on population health. DVACO operates under the Medicare Shared Savings Program (MSSP) and is currently the region’s largest Medicare ACO. For more information please visit www.dvaco.org.

About Humana
Humana Inc., headquartered in Louisville, Ky., is a leading health and well-being company focused on making it easy for people to achieve their best health with clinical excellence through coordinated care. The company’s strategy integrates care delivery, the member experience, and clinical and consumer insights to encourage engagement, behavior change, proactive clinical outreach and wellness for the millions of people we serve across the country.

More information regarding Humana is available to investors via the Investor Relations page of the company’s web site at www.humana.com, including copies of:

  • Annual reports to stockholders;
  • Securities and Exchange Commission filings;
  • Most recent investor conference presentations;
  • Quarterly earnings news releases;
  • Replays of most recent earnings release conference calls;
  • Calendar of events; and
  • Corporate Governance information.

For more information:
Jeff Blunt
Humana Corporate Communications
513-826-7094
jblunt@humana.com

Bridget Therriault
DVACO
484-580-1025
TherriaultB@MLHS.ORG

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 APM model. CMS’s rationale is that the APM’s require many of the same initiatives as needed to be successful in MIPS – and indeed, at the DVACO we are already publicly reporting quality, patient experience, requiring EMR, and tracking efficiency.

Frankly, we have a lot of opportunity to improve on the total cost of care in this region. As clinicians and clinical leaders, we should be advocates for this from a patient safety perspective – first and foremost we should not be using society’s resources on services that our own specialty societies* have determined may cause harm, or are not in line with our patients’ goals of care, or those that provide no meaningful marginal benefit.

By focusing on these opportunities we can truly achieve the triple aim of improving quality, care experience, and cost. The work of the DVACO and the local work taking place in our underlying Clinically Integrated Networks at Main Line, Jefferson, Holy Redeemer, and Doylestown Health form the foundation for success of our community’s clinicians in payment changes that are coming our way very soon.

For a simple graphic of the timeline of CMS payment transformation: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/Timeline.PDF
For information on common care patterns where there is great opportunity to improve value, see www.choosingwisely.org

Medicare ACOs Continue to Improve Quality of Care, Generate Shared Savings

Delaware Valley ACO experiences significant success after first year of participation

The Centers for Medicare & Medicaid Services today issued 2014 quality and financial performance results showing that more Medicare Accountable Care Organizations (ACOs) continue to generate financial savings while improving the quality of care for Medicare beneficiaries by fostering greater collaboration between doctors, hospitals, and health care providers.

When an ACO demonstrates that it has achieved high-quality care and effectively reducing spending of health care dollars above certain thresholds, it is able to share in the savings generated for Medicare. In 2014, 20 Pioneer and 333 Shared Savings Program ACOs generated more than $411 million in savings, which includes all ACOs savings and losses. The results also show that ACOs with more experience in the program tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of health care dollars – it is able to share in the savings generated for Medicare.

Delaware Valley ACO (DVACO) was one of the ACOs that generated shared savings.

“We at DVACO are very pleased with this early validation of our commitment to moving the business model of health care from one strictly based on volume to one based upon value, ultimately improving health outcomes and the patient care experience,” said Katherine Schneider, MD, President and CEO of DVACO. “These early results speak to the challenging transformational work that has been taking place in our hospitals and physician practices—all with a focus on delivering superior care at a sustainable cost for our regional economy and the communities we serve. On behalf of the entire DVACO team, I extend my deepest gratitude to our member physicians for their work thus far, and I am looking forward to continuing our partnership as we make significant progress in this complex transition to value-based care.”

Additional Resources
Visit the Medicare Shared Savings Program News and Updates webpage to access the HHS press release and fact sheet, the link to the Performance Year 2014 results file, and to learn more about the program.

About Delaware Valley ACO
The Delaware Valley Accountable Care Organization (DVACO) is a limited liability company that is owned by Main Line Health, Jefferson University and Hospitals, Holy Redeemer Health System, Doylestown Health, and Magee Rehabilitation Hospital. DVACO’s purpose is to enhance the quality of health care and reduce the growth rate of health care costs by acting as a convener, accelerator, and provider of the foundation needed to assist its participating members to transition from fee for service model, a business model focused on volume to a model focused on population health. DVACO operates under the Medicare Shared Savings Program (MSSP) and is currently the region’s largest Medicare ACO. For more information please visit www.dvaco.org.

For more information:
Bridget Therriault
DVACO
484-580-1025
TherriaultB@MLHS.ORG

Delaware Valley ACO Adopts Wellcentive’s Value-Based Care Solution to Manage 100,000+ Lives

Leading Accountable Care Organization will rely on Wellcentive solutions for population health, quality initiatives and advanced care management

ATLANTA—Aug. 3, 2015—Wellcentive, the leader in population health management and value-based care solutions, announced that it has signed a five-year agreement to deliver products, services and expanded care management capabilities for the Delaware Valley Accountable Care Organization(DVACO)—one of the largest Medicare Shared Savings Program ACOs in the U.S. Wellcentive will support DVACO’s mission to improve the health of its populations and streamline their transition to value-based reimbursement models.

DVACO is a consortium founded and owned by five innovative Philadelphia-area health systems— Thomas Jefferson University Health System , Main Line Health®, Doylestown Health, Holy Redeemer Health System and Magee Rehabilitation Hospital—that recognized the need for collaboration to transform care delivery and adopt value-based reimbursement. The ACO currently covers around 65,000 Medicare beneficiaries, and is expected to grow significantly in the coming years. In addition to its Medicare Shared Savings Program contract, the ACO is preparing to extend its value-based approach to other payers and purchasers.

“We are looking forward to partnering with Wellcentive as DVACO continues to make significant progress in this complex transition to value-based care,” said Katherine Schneider, M.D., M.Phil., FAAFP, president and CEO at Delaware Valley ACO. “As our organization continues to grow and evolve, our ability to implement data driven processes to actively manage our populations and control costs is absolutely critical. Wellcentive demonstrated advanced capabilities to help guide our quality initiatives and patient outcomes, ultimately supporting the health of our patient populations and the success of DVACO as we position ourselves during this transformative time for the industry.”

In addition to the capabilities of Wellcentive’s solution, DVACO cited the company’s 10 years of exclusive focus on population health in the provider setting and strong commitment to innovatively partnering with its customers as key factors in its selection.

“DVACO’s mission and success in convening providers to accelerate and facilitate a transition to value- based, population health-focused approach to business offers model for the industry,” said Tom Zajac, Wellcentive’s CEO. “Wellcentive and DVACO are driven by the same vision—enhancing the care of populations, improving the quality of that care, and reducing overall cost. We are excited to partner with them to bring their vision to reality and deliver value for the Philadelphia region.”

DVACO required a comprehensive, unified solution to support its advanced approach to care management, quality programs, population outreach, and risk management. The partnership with Wellcentive will provide:

  • Data aggregation across its partners and entities, including disparate EMR, clinical and claims systems, enhanced by facilitated data quality services to ensure accurate, complete, and reliable data for driving improvement.
  • Analytic and workflow solutions for tracking, reporting and improving performance on a broad spectrum of clinical quality measures—including measures for Shared Savings and commercial payer programs.
  • Expanded care management and population outreach capabilities, including a flexible framework for community and individual care plans that can adapt to the evolving requirements of value-based care.

About Delaware Valley ACO
The Delaware Valley Accountable Care Organization (DVACO) is a limited liability company that is owned by Main Line Health, Jefferson University and Hospitals, Holy Redeemer Health System, Doylestown Health, and Magee Rehabilitation Hospital. DVACO’s purpose is to enhance the quality of health care and reduce the growth rate of health care costs by acting as a convener, accelerator, and provider of the foundation needed to assist its participating members to transition from fee for service model, a business model focused on volume to a model focused on population health. DVACO operates under the Medicare Shared Savings Program (MSSP) and is currently the region’s largest Medicare ACO with more than 430 primary care physicians and over 65,000 Medicare fee-for-service beneficiaries. For more information please visit www.dvaco.org.

About Wellcentive
Since 2005, Wellcentive has driven quality improvement, revenue growth, and business transformation for providers, health systems, employers, and payers transitioning to value-based care. Recognized as an industry leader for delivering immediate, tangible results, Wellcentive’s analytics simplify complex data from all points of care, advancing comprehensive care management and payer collaboration. Customers benefit from intelligence gained from 15 billion data points each year, improving outcomes for 30 million patients and generating more than $500 million annually in value-based revenue. Visit www.wellcentive.com; follow us on Twitter, LinkedIn and Facebook; or call 877-213-8456 to learn more.

For more information:
Bridget Therriault
DVACO
484-580-1025
TherriaultB@MLHS.ORG

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.

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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 the team here at DVACO is excited to be right in the middle of it all!

 

DVACO Care Coordination: Supporting Primary Care

The Care Coordination department launched in the fall of 2014, with the addition of the Director of Care Coordination, Ann Marks, RN, who brings over 25 years of experience within payer and provider sectors serving special needs populations. In October 2014, the DVACO added two of its first RN care coordinators, who have since assisted over 500 patients with complex care needs. The DVACO’s care coordination team works with patients in collaboration with their primary care providers, specialists, hospital-based care managers, practice-based care coordinators, and a multitude of agencies, in an effort to reduce fragmentation of patients’ care. Our care coordinators complement existing care coordinators within the health systems’ employed practices or other ambulatory settings. Our goal is to serve as an extension of the primary care providers’ staff.

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As the DVACO evolves, we seek ways to improve patient care. This requires utilizing experienced care coordinators who are primarily registered nurses or social workers, along with standardized processes for identifying patients within the population who are most likely to benefit from enhanced care coordination. Technology to support a standardized care coordination process is imperative, and includes patient identification, stratification, data analysis, care planning, alerts about gaps in care, and documentation of the overall care coordination process.

A key component of the quality measures we use to evaluate the success of care coordination is continuous monitoring of emergency department utilization and inpatient hospital admissions rates. DVACO also helps monitor the patient’s transition of care from hospital to nursing home or home health, as well as to and from the patient’s own home setting. This includes evaluation of access and adherence to prescribed medications, scheduling of followup appointments, and assessment of patient barriers to recovery. Our care coordinators then develop a care plan with the patient and primary care provider to help track the identified problems, goals and interventions.

The DVACO Care Coordination department welcomes the opportunity to meet with providers and organizations to discuss the care coordination program. A secure email and toll-free number have been established for practices or facilities to refer a DVACO patient for evaluation of care coordination needs. Email us at Carecoordrefer@dvaco.org or call 1-855-598-4225.

Katherine A. Schneider, MD, Named President of DVACO

TN-214012_Katherine_Schneider_Headshot_June20121Katherine A. Schneider, MD, has been named President and CEO of the Delaware Valley Accountable Care Organization (DV-ACO). Dr. Schneider will provide leadership, strategic direction and ongoing administration and management for all aspects of the DV-ACO. She was selected for this role after an exhaustive search by a committee with representation from each of the organization’s five owners — Main Line Health, Jefferson Health System, Holy Redeemer Health System, Magee Rehab and Doylestown Hospital. Dr. Schneider succeeds David F. Simon who has served as CEO of the DV-ACO since its inception. Her appointment was planned to coincide with the conclusion of Simon’s responsibilities as JHS Executive Vice President and Chief Legal Officer, which resulted from the JHS restructuring earlier this year. Simon’s future endeavors include returning to full time law practice in 2015, as well as continuing as Chairman of the Pennsylvania eHealth Partnership Authority.

DV-ACO Board Co-Chairs, Jack Lynch, President and CEO of Main Line Health, and Stephen Klasko, MD, President and CEO of Thomas Jefferson University and Jefferson Health System, expressed their excitement regarding the future of the organization: “We are incredibly grateful to David for his work in successfully positioning the DV-ACO for the future, and we are confident that Dr. Schneider’s clinical experience and business ingenuity will situate the DV-ACO as a pioneering model of care delivery as we partner with our physicians to deliver exceptional patient care while lowering health care costs.”

“I am honored to be chosen as the new leader tasked with ensuring the continued growth and success of the Delaware Valley Accountable Care Organization,” said Dr. Schneider. “As our nation undergoes a fundamental shift in the design and delivery of health care, I believe that DV-ACO will lead the way in population health improvement by streamlining clinical integration while enhancing the quality and personalization of patient care.”

The DV-ACO is the region’s largest Medicare Accountable Care Organization with more than 400 primary care physicians. DV-ACO began participating in the Medicare Shared Savings Program in January 2014, and since that time, 32,000 Medicare fee-for-service beneficiaries have been assigned to the DV-ACO.

Dr. Schneider comes to DV-ACO from Medecision, where she served as Executive Vice President and Chief Medical Officer. The company is the leading provider of health care management and care coordination software solutions serving national, regional and local health plans, insurers and provider-based organizations. Prior to her role at Medecision, Dr. Schneider served as Senior Vice President, Health Engagement, for the southeastern New Jersey health system AtlantiCare, where she held numerous leadership roles, including founding Board Chair of the Accountable Care Organization and co-designer of a value-based health insurance benefit for 10,000 employees and dependents. Before joining AtlantiCare, Dr. Schneider worked at Middlesex Health System in Connecticut where she held various roles with increasing responsibility, ultimately serving as Chief Medical Officer of the clinically integrated entity. In this role, she led the system’s participation in CMS’s Physician Group Practice Demonstration Project, the pilot precursor to the Medicare Shared Savings Program.

After graduating magna cum laude from Smith College with a degree in biochemistry, Dr. Schneider went on to receive her Master of Philosophy in Epidemiology and medical degree from Columbia University. She completed her medical residency in Family Medicine at Middlesex Health System. She is a Diplomate for both the American Board of Family Medicine and for Clinical Informatics subspecialty, American Board of Preventive Medicine. From 2010 to 2012, Dr. Schneider was appointed by United States Secretary of Health and Human Services (HHS) Kathleen Sebelius to serve on the National Advisory Council, Agency for Healthcare Research and Quality (AHRQ) of the US Department of HHS.

A mother and stepmother of four young adult children, Dr. Schneider resides in Philadelphia with her husband, William R. Petricone, Jr., JD, MD.

Doylestown Hospital and Primary Care Physician Network Join Delaware Valley ACO

Doylestown Hospital and nearly 50 primary care physicians on the Doylestown Hospital Medical Staff have agreed to join Delaware Valley ACO (“DV-ACO”), the largest Medicare Accountable Care Organization in Southeastern Pennsylvania. With this addition, DV-ACO will have approximately 400 primary care physicians in its Medicare ACO.

In 2014 DV-ACO began participating in the Medicare Shared Savings Program with the twin objectives of improving the quality of care and generating cost efficiencies through better care coordination. Currently, over 30,000 Medicare fee-for- service beneficiaries are attributed to DV-ACO. This number will increase substantially in 2015 with the addition of Doylestown Hospital and its affiliated primary care practices and several other primary care practices in Southeastern PA and southern NJ.

“Delaware Valley ACO gives Doylestown Hospital and our primary care physicians the opportunity to collaborate with other elite health systems,” said Jim Brexler, President and CEO of Doylestown Hospital. “The ACO framework complements the work we are already doing within the Doylestown medical community to sharpen our focus on clinical integration, a key goal of our strategic vision for the future.”

“We are very excited about Doylestown Hospital and its well-regarded clinical community joining Delaware Valley ACO,” stated David F. Simon, DV-ACO President and CEO. “We also welcome Doylestown Hospital as a co-owner of the ACO, and look forward to working collectively to improve the health of the Delaware Valley community.”

Who is DVACO?

We are the area’s largest Accountable Care Organization, leading the way in health improvement by streamlining provider participation to enhance the quality and personalization of patient care. Learn More

Contact Info

Address
PO Box 356,
Villanova, PA 19085
Phone 610-225-6295
Toll Free Number 855-761-9345
TTY# 610-225-6275
Email dvacomail@dvaco.org
Business Hours 9-5pm