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North Bay Business Journal

Thursday, January 10, 2013, 10:43 am

Meritage Medical Network granted ACO status

Becomes first to gain such approval in North Bay

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    Meritage Medical NetworkNOVATO — The Meritage Medical Network today was approved as an accountable care organization under a Medicare initiative stemming from the new health care law.

    Meritage Accountable Organization is one of 106 health care organizations across the country approved as ACOs, which aim to provide better coordination with insurers and providers to produce better patient outcomes. Collectively, the new ACOs approved today will ensure access for some 4 million Medicare beneficiaries to coordinated care, according to Kathleen Sebelius, secretary of federal Health and Human Services Department.

    Since passage of the Affordable Care Act, more than 250 ACOs have been established. Meritage is the first official provider in the North Bay to receive approval. The ACO model is intended to create savings in Medicare generated from lowering growth in costs and utilization, while meeting standards for quality of care.

    “Accountable care organizations save money for Medicare and deliver higher-quality care to people with Medicare,” Secretary Sebelius said in a statement. “Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve.”

    The Centers for Medicare & Medicaid Services has established 33 quality measures on care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations and patient and caregiver experience of care.

    Federal savings from this initiative are up to $940 million over four years, according to HHS.

    Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20 percent of ACOs include community health centers, rural health centers and critical access hospitals that serve low-income and rural communities.

    The groups announced today also includes 15 “advance payment model” ACOs, which are physician-based or rural providers who would benefit from greater access to capital to invest in staff, electronic health record systems, or other infrastructure required to improve care coordination.

    Meritage first indicated it would seek ACO status last year, after significant growth and after creating a host of key partnerships. Among those were the launch of an health maintenance organization with Western Health Advantage and providers at nearly every North Bay hospital except those run by Kaiser Permanante and Sutter Health.

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