The Beth Israel Deaconess Physician Organization (BIDPO) was among the 32 organizations chosen in December 2011 to participate in the CMS Pioneer ACO Model. BIDPO continued to operate during 2012, the first year of the Pioneer model, and in January 2013, a newly designed ACO was launched—the Beth Israel Deaconess Care Organization (BIDCO). In BIDCO, participating hospitals and independent physician groups contract, share risk and build care management systems together.
At BIDCO’s launch, BIDPO and the Beth Israel Deaconess Medical Center agreed to jointly invest a total of $12 million annually for five years in care management and infrastructure to improve the coordination of patient care among the participating physicians and hospitals, and to increase the ability of caregivers to focus on population health management. Today, BIDCO’s providers include more than 2,100 primary care physicians and specialists, as well as several Boston-area hospitals. BIDCO has what it refers to as a tertiary affiliation with Beth Israel Deaconess Medical Center.
BIDCO supports its participating physician practices through various efforts that it refers to collectively as medical management. For example, BIDCO has 15 RN Nurse Care Managers who provide telephonic and home care visits to patients with complex medical and psychosocial needs. Nurse practitioners make home visits to the sickest Medicare Pioneer ACO patients. Quality improvement coordinators support PCPs and their staff in achieving quality incentives set forth in global payment and managed care contracts. Pharmacy consultation is also available to physicians, practices and patients through a collaboration with McKesson. Numerous other efforts fall under BIDCO’s medical management umbrella as well.
In its first year of operation (calendar year 2012), the Beth Israel Deaconess ACO saved 4.2 percent of its budget for patient care, generating shared savings of $15.56 million. In year 2 (2013 performance year) it had $17.38 million in shared savings. From a shared savings perspective, it is the third-best performing Pioneer to date. CMS’ recently released Pioneer evaluation report, which uses statistical modeling and near-market controls to provide a more accurate estimate savings, ranks the ACO fifth best. Its performance on quality is generally in the second quartile compared to the other Pioneer ACOs.
BIDCO provides care for 35,360 assigned beneficiaries in the Boston metropolitan area.