According to CMS, the Pioneer ACO Model is designed to encourage the development of Accountable Care Organizations (ACOs), comprised of groups of doctors and other healthcare providers who work together to provide high quality care for their patients. Monarch will work with CMS to provide traditional Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination.
“We are honored that Medicare officials have selected Monarch Healthcare to participate in this important program dedicated to creating a sustainable health care model that enhances the patient experience and improves outcomes,” said Jay Cohen, M.D., Executive Chairman for Monarch HealthCare. “Monarch has long been committed to providing providers high-quality, affordable care for our community, and we look forward to building upon that success as part of the Pioneer ACO Model.”
As one of a diverse group of leading-edge health care organizations from around the country, Monarch HealthCare was chosen specifically by the Innovation Center to test the effectiveness of several models of care delivery and payment in helping organizations make a rapid transition to higher quality care at a lower cost to Medicare.
“These Pioneer ACOs represent our nation’s leaders in health systems innovation, providing highly coordinated care for patients at lower costs,” said Marilyn Tavenner, Acting Administrator of CMS. “Monarch HealthCare has demonstrated significant experience in providing high quality, coordinated care, and we are excited to partner with them,” Tavenner said.
Under the Pioneer ACO Model, providers will be required to meet quality standards based upon, among other measures, patient outcomes and care coordination. The Pioneer ACO Model includes strong patient protections to ensure that patients have access to and receive high quality care. Under the Pioneer ACO Model, 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.
Today’s announcement was the culmination of a competitive selection process that began in May with the national release of a Request for Applications from CMS. Monarch HealthCare was selected based on its demonstrated capabilities to offer high quality, coordinated care. Previously, Monarch was one of five organizations selected nationwide by The Engelberg Center for Health Care Reform at Brookings and the Dartmouth Institute for Health Policy & Clinical Practice to participate in a 5-year Accountable Care Organization (ACO) pilot.
“This is very good news not only for Monarch HealthCare, but for Medicare beneficiaries in California,”
The Pioneer ACO Model is one of a number of initiatives developed by the new Innovation Center. The Innovation Center was created by the Affordable Care Act to test new models of health care delivery and payment.
Monarch HealthCare is an Independent Practice Association (“IPA”) and is the largest physician organization in Orange County. Formed in 1994, Monarch HealthCare is contracted with more than 2,300 independent, private-practice physicians who provide health care for approximately 176,000 Orange County residents. Recognized by health plans and business groups for providing high quality care and excellent service, Monarch HealthCare is operated by physicians who have demonstrated their commitment to advancing medical excellence and exemplifying the “patient-first”
For more information about the Pioneer ACO Model, visit the Pioneer ACO website at www.innovations.cms.gov/
For more information about the Innovation Center, visit innovations.cms.gov.