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Massachusetts ACO Certification Program Now Includes 17 Members

January 5, 2018
by Rajiv Leventhal
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Netwon, Mass.-based Atrius Health has been certified as an accountable care organization (ACO) by the Massachusetts Health Policy Commission (HPC) in what officials call is a first-in-the-nation certification program.

The Massachusetts HPC is an independent state agency that develops policy to reduce healthcare cost growth and improve the quality of patient care. The HPC’s first round of ACO certification includes 17 HPC-certified ACOs, making Massachusetts the first state to implement state-wide, all-payer standards for care delivery, according to the announcement. In the spring of 2017, the HPC announced the certification of two ACOs under a beta testing phase of the application system: Boston Accountable Care Organization (BACO), and Community Care Cooperative (C3). Then in late December, the HPC announced that it has certified 15 additional ACOs

The HPC’s ACO Certification Program is closely aligned with efforts by the Executive Office of Health and Human Services (HHS) and the Office of MassHealth to improve health and reduce healthcare cost growth in the Commonwealth through ACOs. The broad goal is a healthcare delivery system that delivers coordinated, patient-centered health care that accounts for patients’ behavioral, social, and medical needs, officials noted.

For the first year of the program, the HPC defined a set of criteria on which to assess ACOs for certification against that goal. However, unlike other state or federal programs, the HPC’s certification program evaluates ACOs on an all-payer basis, including for their Medicaid, Medicare, and commercially-insured patient populations.

The HPC-certified ACOs include a cross-section of 17 health care organizations from across the Commonwealth. Importantly, the HPC will certify all organizations participating in the MassHealth ACO program.

“The ACO program represents a significant change in the way MassHealth contracts with healthcare organizations throughout the state,” Massachusetts Secretary for Health and Human Services, Marylou Sudders, said in a statement. “The goal of the ACO program is to improve the care coordination and health outcomes for 850,000 MassHealth members and we are pleased they all met the thorough certification standards.”

Atrius Health, for one, has a long history of working with the Centers for Medicare and Medicaid Services (CMS) and commercial payers in various value-based care programs. As one of the 32 organizations originally selected as a CMS Pioneer ACO, Atrius Health ranked first nationally in quality scores after completing the fifth and final year of the model in 2016. Currently as a CMS Next Generation ACO and a MassHealth ACO partner with Tufts Health Plan, the organization continues to look to innovate care delivery through coordinated, preventive services and by moving the site of care to lower-cost ambulatory, home and virtual settings, its officials attest.

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