Nightingale Awards for Excellence in Nursing

Congratulations to Adele Pike, Director of Education, who was asked to speak at the annual Nightingale Awards for Excellence in Nursing sponsored by Greater Hartford VNA.   The Nightingale Awards for Excellence in Nursing program was originally developed by the Visiting Nurse Association of South Central CT to be a collaborative effort to celebrate outstanding nurses and elevate the nursing profession.   The goals of the program are to encourage retention, inspire future nurses, focus public attention and recognize the breadth and scope of nursing practice at the local level. Well done Adele!

Massachusetts College of Pharmacy and Health Sciences Recognition

Massachusetts College of Pharmacy and Health Sciences (MCPHS) has recognized the VNA Care Network's Physical Therapy Department as a Clinical Site of Excellence. This award recognizes the Physical Therapy Department's involvement with MCPHS's program, including mentoring students in the Integrated Clinical Experiences course and capstone  Physical Therapy clinical experiences, involvement with panel discussions, and participation with students as "mock" patients. The award also recognizes Jan Silvestry's membership on the MCPHS Clinical Education Advisory Board.

(l-r) Jan Silvestry, PT, MA, Rehabilitation Services Manager, Linda Tsoumas, PT, MS, EdD. Dean and Professor of Physical Therapy at MCPHS, Cheryl Babin, PT, MHA, CAGS, Academic Coordinator of Clinical Education/Assistant Professor at MCPHS, and Wendy Drake, MSPT, Rehabilitation Services Manager

Photo: Members of VNA Care Network's Physical Therapy team who participated in the Integrated Clinical Experiences program came together in Southborough last week to attend the award presentation from MCPHS.

Moving Forward Update

The announcement below from Health and Human Services states that the official evaluation of the Pioneer ACO model done by an independent evaluator, in conjunction with the CMS Office of the Actuary, has been completed and shows that the Pioneer ACO program has successfully demonstrated that it saved money and increased quality, meeting the test for success as set out for Center for Medicare and Medicaid Innovation (CMMI) in the Affordable Care Act. This is good news for CMMI -- both as a validation of the Pioneer model and as a first demonstrated success for CMMI -- it also demonstrates that accountable care can reduce the growth in costs while also improving quality.

 Atrius Health has demonstrated in this evaluation that we can significantly reduce the cost of care as compared with local trends while scoring the highest on quality measures among New England ACOs. Congratulations and thanks to all of you who have been working on the Pioneer ACO program and improving the care of our Medicare patients.

Affordable Care Act payment model saves more than $384 million in two years, meets criteria for first-ever expansion

Today, an independent evaluation report released by the Department of Health and Human Services showed that an innovative payment model created as a pilot project by the Affordable Care Act generated substantial savings to Medicare in just two years. Additionally, the independent Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) has certified that this patient care model is the first to meet the stringent criteria for expansion to a larger population of Medicare beneficiaries.

The independent evaluation report for CMS found that the Pioneer Accountable Care Organization (ACO) Model generated over $384 million in savings to Medicare over its first two years - an average of approximately $300 per participating beneficiary per year - while continuing to deliver high-quality patient care. The Actuary's certification that expansion of Pioneer ACOs would reduce net Medicare spending, coupled with Secretary Sylvia Mathews Burwell's determination that expansion would maintain or improve patient care without limiting coverage or benefits, means that HHS will consider ways to scale the Pioneer ACO Model into other Medicare programs.

"This is a crucial milestone in our efforts to build a health care system that delivers better care, spends our health care dollars more wisely, and results in healthier people," said HHS Secretary Sylvia M. Burwell. "The Affordable Care Act gave us powerful new tools to test better ways to improve patient care and keep communities healthier. The Pioneer ACO Model has demonstrated that patients can get high quality and coordinated care at the right time, and we can generate savings for Medicare and the health care system at large."

The Pioneer ACO Model, one of the first payment models launched by CMS, gives experienced health care organizations accountability for quality and cost outcomes for their Medicare patients. Doctors and hospitals who form Pioneer ACOs can share in savings generated for Medicare if they work to coordinate patient care, keep patients healthy and meet certain quality performance standards, or they may be required to pay a share of any losses generated.

Currently, the Pioneer ACO Model is serving more than 600,000 Medicare beneficiaries. According to today's report, compared to their counterparts in regular fee-for-service or Medicare Advantage plans, Medicare beneficiaries who are in Pioneer ACOs, on average:

• Report more timely care and better communication with their providers.
• Use inpatient hospital services less and have fewer tests and procedures.
• Have more follow-up visits from their providers after hospital discharge.

Pioneer ACOs are part of the innovative framework established by the Affordable Care Act to move our health care system toward one that rewards doctors based on the quality, not quantity, of care they give patients. HHS earlier this year announced the ambitious goal of tying 30 percent of Medicare payments to quality and value through alternative payment models by 2016 and 50 percent of payments by 2018. More than 3,600 payers, providers, employers, patients, states, consumer groups, consumers and other partners have registered to participate in the Health Care Payment Learning and Action Network, which was launched to help the entire health care system reach these goals.
 

Pioneer ACOs generated Medicare savings of $279.7 million in 2012 and $104.5 million in 2013. To date, actuarial analyses show that ACOs in the Pioneer ACO Model and the Medicare Shared Savings Program have generated over $417 million in total program savings for Medicare. The primary analyses in the evaluation are also reported in an article published in the Journal of the American Medical Association today.

 "This success demonstrates that CMS can design and test innovative payment and service delivery models that produce better outcomes for the Medicare program and beneficiaries," added Patrick Conway, MD, the acting principal deputy administrator of CMS. "This gives CMS greater confidence in scaling elements of the model to benefit people across the nation, and we are working to determine the best strategies for embedding the lessons we have already learned from the Pioneer Model into permanent Medicare programs and our nation's health system."

 To view the CMS Office of the Actuary Certification of Pioneer ACO Model savings, click here.