Dr. Nick Turkal, the system's president and CEO, said he was pleased that expanded coverage and provisions to overhaul healthcare delivery, such as accountable care, survived, though “the law falls short of really reforming healthcare in our country.”
New York City's public health system told Medicare officials of plans to apply to join the Medicare shared-savings program for ACOs starting in 2013.
Alan Aviles, president and CEO of the New York City Health and Hospitals Corp., said the outcome would give focus and momentum to efforts to revamp healthcare delivery “and result, hopefully, in improvement in efficiency and quality that remain the central challenge before us.”
Aviles said accountable care, as an approach to revamping incentives to promote quality and reduce costs, has gained “a fair amount of momentum,” and Medicare's move toward the model is consistent with the direction of the industry and the system.
Indeed, executives engaged in ACOs said the efforts would have continued, regardless of the decision.
“The emphasis on a higher value, more-organized, better coordinated healthcare system that provides better quality and focuses a great deal on providing better quality has started, and that's not going to stop,” said Jeff Squier, executive director for Bellin ThedaCare Healthcare Partners, another Pioneer ACO.
Catholic Medical Partners operates eight accountable care contracts, including private-market ACOs and a Medicare ACO that covers 30,000 and stands to generate $260 million of revenue for the Buffalo, N.Y.-based provider.
“We're doing this anyway,” Dennis Horrigan, president and CEO of Catholic Medical Partners, one of 27 organizations to win some of the first Medicare accountable care contracts made possible by the Patient Protection and Affordable Care Act.
Healthcare spending cannot continue to grow unchecked, and providers face pressure from employers, households and governments to curb spending, said Chuck Lehn, CEO of the Banner Health Network, which oversees the health system's ACO. “Practically speaking, the underlying problem does not go away.”
Hospitals, medical groups and commercial insurers will continue with efforts, such as accountable care, that seek to better coordinate medical care and improve the quality of medicine, he said. “Everybody's got their head down working on it,” Lehn said.
Banner Health launched its Medicare ACO in January under the Center for Medicare & Medicaid Innovation. The Phoenix-based system, which owns or operates 22 hospitals, has roughly 52,000 seniors in its Medicare ACO.
John Hensing, Banner's executive vice president and chief medical officer, said an aging population and rising health spending are creating demand for greater efficiency, more collaboration and new incentives that reward hospitals and doctors that keep people healthy “almost regardless of what the Supreme Court said.” The ruling, he said, “doesn't change that activity, and we'll continue to pursue it.”