Vermont Business Magazine The Adirondacks ACO and OneCare Vermont ACO have formed a stronger working relationship between their accountable care organizations, which are the two largest ACOs in the Vermont and northern New York regions. The approach includes common CEO leadership and sets course for shared services and infrastructure to efficiently meet their missions. This model is not a merger and each ACO retains its own corporate identity, contracts, and governance. OneCare is motivated by getting a lump sum of funding. By reducing treatment costs (largely by reducing duplication of services) and increasing outcomes, member providers make more money; if they do not, they bear the financial burden of any cost overruns.
The Boards of both OneCare and Adirondacks ACO endorsed the model and the appointment of Todd Moore as CEO of both organizations in their September 2017 meetings. Kevin Stone, Chair of the OneCare Vermont Board said, “Under Todd’s leadership, OneCare has built a very strong management team and I am confident that with Todd’s ongoing direction, our collective administrative performance will remain strong. Most importantly, this aligned approach with the Adirondacks ACO will provide us with an opportunity to share knowledge and learn best practices to better serve our communities and the patients we collectively serve. This now sets the stage to realize economies of scale in our administrative infrastructure for ongoing sustainability.”
Todd Moore, CEO of OneCare, will work with the Adirondacks ACO Board, chaired by John Rugge, M.D., founder and Executive Chairman of Hudson Headwaters Health Network (HHHN), which operates Federally Qualified Health Centers (FQHCs) across the northern New York region. Dr. Rugge said, “We look forward to working with Todd and the OneCare team and believe this will provide positive benefits for patients in New York.”
Stephens Mundy, CEO and President of the University of Vermont Health Network’s Adirondack Region and Adirondacks ACO Board member said, “Northern New York and Vermont have striking similarities in both need and opportunity for population health management and value-based incentives for providers. The assumption of downside risk even at a limited level makes this the perfect time to align our provider and patient-focused efforts which are shown to work in regions like ours.”
The Adirondacks ACO and OneCare have had a strong history of collaboration since the Adirondacks ACO was founded in 2014. Over the past three and a half years, the two ACOs have made aligned selections on tools for data and analytics, with OneCare providing contracted data management services to the Adirondacks ACO. The ACOs have also built strong peer-to-peer relationships which include the sharing of clinical best practices and quality measurement and improvement tools. Now with a common senior leadership approach, there is opportunity to gain administrative efficiencies and develop a more coordinated system of health across a wide region.
OneCare is currently piloting the Vermont Medicaid Next Generation program which involves significant financial and quality accountability and in 2018 will participate in the Medicare Next Generation program. OneCare is also in substantive discussion on a risk-based commercial program with Blue Cross Blue Shield of Vermont. The Adirondacks ACO is currently enrolled in the Medicare Shared Savings Program and has recently added a number of commercial and New York Medicaid contracts to administer a multi-payer medical home program. This provides added funds to support primary care and introduces ACO-wide risk of approximately 1% on total cost of care.
Dr. Toby Sadkin, family physician, Chair of Primary Care Health Partners and OneCare Board member, lauded the partnership. Dr. Sadkin said, “We are particularly excited about the opportunities this partnership creates to realize greater operational efficiencies in our community provider health practices. As a small community primary care practice, we know firsthand how important it is for all of us along the continuum of care – from hospitals to home health to primary care – to work together to improve the quality of care for the people of Vermont and New York.”
Moore assumed the role of CEO of Adirondacks ACO on October 1, 2017 and will be working with both ACOs on 2018 budgets through the fall.
About Adirondacks ACO
Adirondacks ACO is a physician-hospital partnership working with Medicare, NYS Medicaid and Commercial Insurance Programs across northern New York. This approach seeks to change the practice of healthcare delivery across the region, resulting in decreased utilization, increased efficiencies and enhanced quality of care for our residents. The Adirondacks ACO includes an extensive provider network of more than 450 participating primary and specialty clinicians with five partner hospitals who work to coordinate health care for about 26,000 Medicare beneficiaries; 80,000 commercially insured beneficiaries and 25,000 managed Medicaid beneficiaries in Clinton, Franklin, Essex, Hamilton, Warren, Washington and Northern Saratoga County in New York.
About OneCare Vermont ACO
OneCare Vermont is a state-wide Accountable Care Organization (ACO) working with Medicare, Vermont Medicaid and the Commercial Exchange Programs to improve the health of Vermonters. OneCare Vermont comprises an extensive network of providers, including hospitals in Vermont and New Hampshire, hundreds of primary and specialty care physicians and advance practice providers, federally qualified health centers, and several rural health clinics. OneCare coordinates the health care for more than 100,000 combined Medicare, Medicaid and Commercial Exchange Vermont members.
Source: OneCare 10.5.2017