BAHN to participate as Pioneer Accountable Care Organization

Montefiore Medical Center announced today that its Bronx Accountable Healthcare Network (BAHN), has been selected to participate as a Pioneer Accountable Care Organization (ACO), a transformative new initiative sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. Montefiore's ACO is one of only 32 organizations in the nation, as well as the only one in New York State, to operate under this new model of providing Medicare beneficiaries with higher quality care, while reducing expenditures through enhanced care coordination.

Since 1996, Montefiore, the University Hospital and academic medical center for Albert Einstein College of Medicine, has been a pioneer in developing new healthcare delivery and payment systems. Montefiore has extensive experience contracting with health plans to provide innovative care management services.

CMS estimates that approximately 24,000 traditional Medicare beneficiaries in the Bronx will be served by care coordination options from the Montefiore ACO because of their current or past use of one or more of Montefiore's 2,400 employed and community-based physicians. If Montefiore meets quality standards based on patient outcomes, patient experience and care coordination over the three-year period currently contemplated for the Pioneer program, it will share a percentage of the savings generated over time.

"As an academic medical center with a truly integrated delivery system and unique focus on the community, Montefiore has been practicing accountable care long before the acronym ACO was developed," said Steven M. Safyer, MD, President and CEO Montefiore Medical Center. "Being a Pioneer ACO is consistent with our vision of transforming health care delivery by aligning incentives toward performance rather than fee-for-service transactions, resulting in more patient-centered, coordinated care."

"At Montefiore, we have embarked on a path that has allowed us to provide excellent healthcare to an extremely challenged community," said Joel A. Perlman, Executive Vice President of Finance at Montefiore Medical Center and President of the ACO. "We have formed a highly integrated team of physicians, nurses, social workers, mental health professionals and other caregivers that has enabled us to track and maintain the health of our patients, whether they get care in our ambulatory care centers, our hospitals and community doctors' offices and even in their own homes."

"By focusing on preventing health problems rather than just treating them, Montefiore is a pioneering and proactive care provider," said Stephen Rosenthal, President and CEO of the Care Management Company (CMO) of Montefiore Medical Center and Chief Operating Office of the ACO. "With the start of the Pioneer ACO program in January, we will identify the Medicare "fee for service" beneficiaries most in need of care coordination and implement interventions immediately."

The Pioneer ACO is one of a number of initiatives developed by the new Innovation Center to test new models of health care delivery and payment. The Montefiore ACO was chosen in a competitive process in which it demonstrated its experience in coordinating care for patients across multiple care settings and working with innovative payment models.

Unlike a managed care plan, Medicare beneficiaries in a Pioneer ACO will maintain the ability to see any doctor or healthcare provider, continue to receive the full benefits associated with traditional Medicare as well as receive the ACOs augmented care management services.

"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. "Montefiore's Pioneer ACO has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them."