A Publication of WTVP

For 135 years, OSF HealthCare System has been a leader and innovator in the delivery of healthcare services. A few months ago, we learned that our hospitals, physicians, advanced care practitioners, home care services and pharmacies in central Illinois have been selected to participate as a Pioneer Accountable Care Organization (ACO) with the Centers for Medicare and Medicaid Services (CMS).

This demonstration project, organized through the Center for Medicare and Medicaid Innovation in partnership with CMS, will change the way OSF and the providers who are part of the OSF Healthcare System are reimbursed by Medicare for certain beneficiaries. OSF is one of just 32 systems nationwide selected for this project, chosen for our experience in providing high-quality, coordinated care.

The Pioneer ACO is a group of doctors, hospitals and healthcare providers working together with CMS to give Medicare patients better service, quality and care at a lower cost. The agreement with Medicare lasts for three years and can be extended for up to five. We are honored to be chosen as a Pioneer ACO and believe the goals of this initiative align well with our mission, vision and values.

The goal is for Medicare patients’ healthcare providers to better coordinate the care of their patients to meet the unique, individual needs and preferences of the patients served. That will involve innovative approaches to care coordination and special attention to those with multiple, complex medical problems.

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 this model, Medicare 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.

By analyzing data on the health status of these beneficiaries and coordinating care with all providers, we will collectively enhance the ability of the health delivery system to provide better patient care. If we succeed in providing better care, leading to better health at a reduced cost, we will have improved the value for all involved. In light of the significant number of Medicare patients seen on a yearly basis, and with a greater push than ever to manage healthcare costs, we see this relationship as a good thing for both sides.

Tara Canty is the senior vice president for OSF Healthcare System who oversees our relationship with the state and federal governments. She is excited to be a part of the Pioneer ACO program. “This is a complete win for the Medicare beneficiaries in our communities. OSF will collaborate with CMS and other major healthcare systems to find innovative approaches to improving how we care for patients. And the patients will still have all of the choices they have today.”

You will be hearing more about our Pioneer ACO participation over the next couple of years, especially when it comes to tracking patient outcomes and managing healthcare costs. We look forward to sharing what we expect will be an exciting journey with you.iBi