Southcoast Health announced today that the not-for-profit community health system’s accountable care organizations (ACOs) – Southcoast Accountable Care Organization (SACO) and Southcoast Community Alliance (Medicaid ACO) – received ACO Certification under the Health Policy Commission’s (HPC) new certification standards known as ACO LEAP 2022-2023. The standards reflect HPC’s focus on learning, equity, and patient-centeredness.
Southcoast Health’s ACOs first became HPC-certified in 2017, with SACO – its Medicare ACO – launching in 2013. Southcoast Health was in the first cohort of Medicaid ACOs in Massachusetts launching in 2018, which is operated in partnership with Boston Medical Center Health System. Southcoast Health’s two ACOs are responsible for over 40,000 covered lives in the South Coast region.
“The new certification standards required us to show that we’ve integrated health equity and behavioral health into our care management systems,” said Jay Lawrence, MD, Southcoast Health Senior Vice President, Chief Transformation and Innovation Officer and Physician-in-Chief for Primary Care. “Both are integral to meeting the care needs of patients with MassHealth insurance. Southcoast Health will always be committed to ensuring that every single patient, regardless of socioeconomic status, has access to high-quality health care and that we attend to both the behavioral and physical health needs of patients.”
“The ACO Certification program, in alignment with other state agencies including MassHealth, is designed to accelerate care delivery transformation in Massachusetts and promote a high quality, efficient health system. ACOs participating in the program have met a set of objective criteria focused on core ACO capabilities demonstrating dedication to patient-centered care, use of evidence-based and data-driven strategies to improve care delivery, and commitment to addressing long-standing health inequities,” according to the letter received from the Health Policy Commission confirming the certification.
This certification is for the period of January 1, 2022, through December 31, 2023.
ACOs are comprised of groups of doctors, hospitals, and other healthcare providers that organize themselves to provide coordinated high-quality care to patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. ACOs are successful when they are able to deliver high-quality care and spend healthcare dollars wisely.
The HPC Accountable Care Organization Certification Program is designed to accelerate care delivery transformation in Massachusetts and promote a high-quality, efficient health system. The program complements existing local and national care transformation and payment reform efforts, encourages value-based care delivery, and promotes investments by payers in high-quality and cost-effective care across the continuum. As of 2021, the Health Policy Commission has certified 16 ACOs that collectively represent 2.9 million attributed commercial, Medicare, and MassHealth patients in the Commonwealth.
The HPC ACO LEAP 2022-2023 standards are designed to allow for a variety of ACO approaches to meeting core principles consistent with the “Learning Health System” framework developed by the National Academy of Medicine (formerly the Institute of Medicine). This approach is intended to focus on the ACO model as a catalyst for learning and improvement, recognizing that ACO structures, processes, and approaches are conducive to learning and improvement over time.