CHP: HHC Goes for ACO Status

HHC Goes for ACO Status

Crain’s Health Pulse  July 2, 2012

The city's Health and Hospitals Corp. has formally notified the Centers for Medicare and Medicaid Services that it intends to start an Accountable Care Organization.


As an experiment, the federal government is offering participants potentially higher Medicare payments in exchange for taking on more financial risk, such as getting a capitated fee per patient instead of fee-for-service payments.


If the preventive care the ACO offers results in patients staying healthier, that saves money on health care, savings the ACO then shares with CMS.


"We have just filed a letter of intent to meet the deadline to get an ACO designation in this cycle," HHC President Alan Aviles said last week. The details have not been fully worked out, but it would be a capitated plan, he said.


An HHC spokeswoman said the ACO would be done through MetroPlus, the managed care plan that currently covers 400,000 members. HHC sees 1.4 million patients a year, including 470,000 who are uninsured. Its annual budget is $6.7 billion.