Established in 2004, Atrius Health consists of six community-based medical groups in eastern and central Massachusetts, along with an agency that provides home health care, private duty nursing and hospice services. The alliance has 50-plus practice locations, and more than 1,000 physicians and 2,100 other health professionals.
In 2009, Atrius Health became one of the first organizations to join Blue Cross Blue Shield of Massachusetts (BCBSMA)’s Alternative Quality Contract (AQC) program, considered by many to be an early ACO model. Through that arrangement, Atrius Health coordinates care for BCBSMA members using population management processes to conduct outreach for preventive services and chronic disease management.
Given Atrius’ years of experience with the AQC program, the organization was selected in December 2011 as one of the 32 participants in the Pioneer ACO initiative.
Three of the medical groups—Granite Medical Group, Harvard Vanguard Medical Associates and South Shore Medical Center—collaborated to open two specialized centers: the Atrius Health Cardiovascular Center and the Atrius Health South Shore Pulmonology and Sleep Medicine Group. To promote safer care and reduce the duplication of medical tests, in 2012 Atrius Health worked with Beth Israel Deaconess Medical Center and Epic Systems to create a special web portal that gives clinicians and staff members read-only access to patients’ electronic medical records.
In addition, in 2012 and 2013, the 37 internal medicine practices within Atrius Health’s six physician groups received three-year certification from the National Committee for Quality Assurance as Level Three patient-centered medical homes.
Preliminary results indicated that Atrius Health Pioneer ACO had a shared loss during its first performance year, which would have meant the organization owed the CMS as much as $2 million. However, once the 12-month performance numbers were finalized, the ACO’s actual loss was 0.98 percent, not 2.1 percent as originally reported. Atrius said because the loss was small enough to be considered within the statistical range of error, it did not qualify as a shared loss. The organization also noted that its benchmark “was more challenging” than that of other Pioneer ACOs in the same market because Atrius already had a history of providing coordinated care to Medicare patients.
In its second year, Atrius posted shared savings of $3.15 million.
BY THE NUMBERS: PIONEER ACO PERFORMANCE