As we reported last week, five Boston area hospitals and physician groups will have a dominant role in a federal experiment that could transform Medicare. All Medicare patients who see doctors through Atrius Health, Partners HealthCare, Beth Israel Deaconess Medical Center, Mount Auburn Hospital or any of the Steward Health hospitals will be affected. The question is how?
The Centers for Medicare and Medicaid Services (CMS) today announced 32 organizations that will “Pioneer” the move to accountable care organizations (ACOs). Greater Boston, with five of the 32, will have a large concentration of doctors and patients testing ways to coordinate care and reduce costs.
Medicare rules become the standard for payments and care at most hospitals. So when these major groups in Boston start doing more preventive care or requiring more interaction among all a Medicare patient’s doctors, the same practices will likely apply — eventually — to patients of all ages.
This pilot will not restrict where patients go for care. Hospitals and doctors will be rewarded for beating their prior spending thresholds and for showing patient care improvements. These groups could lose money if patients need more care than they have in the past or if they get a lot of expensive care that isn’t coordinated.
CMS says this experiment could save $1.1 billion over the next five years. That’s a lot of money, but keep in mind that the Medicare budget this year is $468 billion.
We asked leaders of each Boston area organization to answer this question: How will joining this pilot project affect the way you care for Medicare patients? Continue reading