HealthCare Partners Medical Group to Participate as Medicare Pioneer Accountable Care Organization

Online, December 19, 2011 (Newswire.com) - HealthCare Partners Medical Group today announced it has been selected to participate in the Pioneer Accountable Care Organization (ACO) Model, a transformative new initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center.

Through the Pioneer ACO Model, HealthCare Partners Medical Group will work with CMS to provide Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination.

"We are pleased to be part of such an important initiative," said Robert Margolis, MD, HealthCare Partners chairman and chief executive officer. "Since HealthCare Partners Medical Group was founded in 1992, we have been focused on supporting our physicians to provide coordinated healthcare for patients in Los Angeles and Orange counties to improve health outcomes while controlling costs. Coordinated care can improve patient health through intensive patient and family education and earlier treatment of chronic conditions to help prevent complications. We have particularly strong experience in caring for older adults and patients with complex health conditions, and participating in the Pioneer ACO will allow us to partner with other like-minded healthcare organizations to demonstrate how a coordinated care approach allows physicians to help transform the way healthcare is delivered."

The Pioneer ACO Model is designed to encourage the development of ACOs, which are groups of doctors and other healthcare providers who work together to provide high quality care for their patients. As one in a diverse group of leading-edge health care organizations from around the country, HealthCare Partners Medical Group was chosen specifically by the Innovation Center to test the effectiveness of several models of payment in helping organizations make a rapid transition to higher quality care at a lower cost to Medicare.

"These Pioneer ACOs represent our nation's leaders in health systems innovation, providing highly coordinated care for patients at lower costs," said Marilyn Tavenner, Acting Administrator of CMS. "HealthCare Partners Medical Group has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them," Tavenner said.

Under the Pioneer ACO Model, CMS will provide incentives for participating healthcare providers who form an organization to coordinate care for patients. Providers who band together through this model will be required to meet quality standards based upon, among other measures, patient outcomes and care coordination among the provider team.

CMS will use robust quality measures and other criteria to reward ACOs for providing beneficiaries with a positive patient experience and better health outcomes, while also rewarding HealthCare Partners Medical Group for reducing growth in Medicare expenditures for the same patient population.

Unlike a managed care plan, Medicare beneficiaries will not be locked into a restricted panel of providers. The Pioneer ACO Model is not a health plan or managed care plan. Under the Pioneer ACO Model, beneficiaries seeing doctors participating in an ACO will maintain the ability to see any doctor or healthcare provider, as well as the full benefits associated with traditional Medicare.

Today's announcement was the culmination of a competitive selection process that began in May with the national release of a Request for Applications from CMS. HealthCare Partners Medical Group was selected based on its demonstrated capabilities to offer high quality, coordinated care.

The Pioneer ACO Model is one of a number of initiatives developed by the new Innovation Center. The Innovation Center was created by the Affordable Care Act to test new models of health care delivery and payment.

About HealthCare Partners
HealthCare Partners Medical Group has been named a top-performer for eight years in a row by the Integrated Healthcare Association (IHA), and has been recognized by health plans and business groups for medical leadership, the high quality of medical care delivered, operational effectiveness, and high rates of patient satisfaction. The HealthCare Partners physician network cares for nearly 580,000 managed care patients and hundreds of thousands of fee-for-service and PPO patients in the areas of Los Angeles, Long Beach, South Bay, Pasadena/San Gabriel Valley, San Fernando and Santa Clarita Valleys, and Orange County, with more than 1,200 employed and affiliated primary care physicians and more than 3,000 employed and contracted specialists. In addition to primary care doctors' offices, HealthCare Partners provides medical services through urgent care centers and ambulatory surgery centers. For more information, please visit www.healthcarepartners.com.

Helpful Links
For more information about the Pioneer ACO Model, visit the Pioneer ACO website at www.innovations.cms.gov/areas-of-focus/seamless-and-coordinated-care-models/pioneer-aco/.
The Pioneer ACO Model is one of several initiatives underway at CMS designed to encourage the formation of ACOs. For more information, visit www.cms.gov/aco. For more information about the Innovation Center, visit innovations.cms.gov.

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