Morehouse Choice Accountable Care Organization and Education System (MCACO-ES): Integrated Model Delivering Equitable Quality Care

Abstract

Accountable Care Organizations (ACOs) seek sustainable innovation through the testing of new care delivery methods that promote shared goals among value-based health care collaborators. The Morehouse Choice Accountable Care Organization and Education System (MCACO-ES), or (M-ACO) is a physician led integrated delivery model participating in the Medicare Shared Savings Program (MSSP) offered through the Centers for Medicare and Medicaid Services (CMS) Innovation Center. The MSSP establishes incentivized, performance-based payment models for qualifying health care organizations serving traditional Medicare beneficiaries that promote collaborative efficiency models designed to mitigate fragmented and insufficient access to health care, reduce unnecessary cost, and improve clinical outcomes. The M-ACO integration model is administered through participant organizations that include a multi-site community based academic practice, independent physician practices, and federally qualified health center systems (FQHCs). This manuscript aims to present a descriptive and exploratory assessment of health care programs and related innovation methods that validate M-ACO as a reliable simulator to implement, evaluate, and refine M-ACO’s integration model to render value-based performance outcomes over time. A part of the research approach also includes early outcomes and lessons learned advancing the framework for ongoing testing of M-ACO’s integration model across independently owned, rural, and urban health care locations that predominantly serve low-income, traditional Medicare beneficiaries, (including those who also qualify for Medicaid benefits (also referred to as “dual eligibles”). M-ACO seeks to determine how integration potentially impacts targeted performance results. As a simulator to test value-based innovation and related clinical and business practices, M-ACO uses enterprise-level data and advanced analytics to measure certain areas, including: 1) health program insight and effectiveness; 2) optimal implementation process and workflows that align primary care with specialists to expand access to care; 3) chronic care management/coordination deployment as an effective extender service to physicians and patients risk stratified based on defined clinical and social determinant criteria; 4) adoption of technology tools for patient outreach and engagement, including a mobile application for remote biometric monitoring and telemedicine; and 5) use of structured communication platforms that enable practitioner engagement and ongoing training regarding the shift from volume to value-based care delivery.

The implementation of value-based healthcare: a scoping review

“…Six conceptualized value in VBHC [26][27][28][29][30][31], six conceptualized goals of VBHC [7,[32][33][34][35][36] and three conceptualized both value and goals in VBHC [37][38][39]. The remaining articles (N = 11) did not include a conceptualization of VBHC [40][41][42][43][44][45][46][47][48][49][50].…”

The Research Centers in Minority Institutions (RCMI) Translational Research Network: Building and Sustaining Capacity for Multi-Site Basic Biomedical, Clinical and Behavioral Research

“…The RCMI consortium partners include health systems implementing innovative payment models, such as Accountable Care Organizations (ACO), 31 and population health resources such as illness registries or specimen banks. 32 RTRN is coordinating efforts to leverage these population health resources by deploying informatics tools such as i2b2, 9 that will support data science initiatives, and accelerate research on the science of health disparities.…”

Community-Based Participatory Research in Action: The Patient-Centered Medical Home and Neighborhood

“…Later, the MSM model and the ACO model were merged. 13 Collaborations with community agencies were also critical during this period. These partnerships allowed for important resource referrals for patients served; such as diabetes management classes, exercise and nutrition resources, smoking cessation classes, bill pay assistance and transportation assistance Central to all of these partnerships was the recruitment of CHWs from the neighborhood to ensure integrated community knowledge.…”