UCLA Health System chosen as a Medicare Shared Savings Program accountable care organization

January 18, 2013

5 min read

The Centers for Medicare and Medicaid Services (CMS) has announced that the UCLA Health has been selected to participate in the federal government's Medicare Shared Savings Program as an accountable care organization.

As a participant in the program, the UCLA Health will work with CMS to provide high-quality service and care to Medicare fee-for-service beneficiaries while reducing the growth in Medicare expenditures through enhanced care coordination.

"Through participation in the Medicare Shared Savings Program and other initiatives, UCLA is taking an innovative approach to health care, focusing on high-value, high-quality care that is truly patient-centered," said Dr. Molly Coye, chief innovation officer for the UCLA Health. "UCLA aims to be a leader in transforming health care and reining in uncontrolled health care costs."

The Medicare Shared Savings Program was created under the Affordable Care Act to help health care providers better coordinate care for Medicare fee-for-service beneficiaries through accountable care organizations, or ACOs — groups of doctors, hospitals and others who collaborate to provide high-quality service and care for their patients.

"UCLA Health has truly outstanding, high-quality, evidence-based medical programs, and the Medicare Shared Savings Program provides us with an important framework to better coordinate care for our Medicare fee-for-service beneficiaries," said Dr. David Feinberg, president of the UCLA Health, CEO of the UCLA Hospital System and associate vice chancellor for health sciences at UCLA.

By creating its own ACO, the UCLA Health was able to submit an application to participate in the program. UCLA was chosen specifically by CMS to create incentives for health care providers to work together to treat individual patients across care settings — including doctors' offices, hospitals and other health care facilities.

"Accountable care organizations save money for Medicare and deliver higher-quality care to people with Medicare," said U.S. Secretary of Health and Human Services Kathleen Sebelius. "Thanks to the Affordable Care Act, more doctors and hospitals are working together to give people with Medicare the high-quality care they expect and deserve."

The Shared Savings Program will reward ACOs that lower the growth of health care costs while meeting performance standards for quality of care and putting patients first. The participation of health care providers in an ACO is purely voluntary.

ACOs must meet quality standards to ensure that savings are achieved through improved care coordination and the provision of care that is appropriate, safe and timely. CMS has established 33 quality measures on care coordination and patient safety, the appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care. Federal savings from this initiative are up to $940 million over four years.

"UCLA Health is one of only a few academic medical centers to participate in this program," said Dr. Samuel A. Skootsky, chief medical officer of the UCLA Faculty Practice and Medical Group. "UCLA Health has a strong foundation in primary care, including a 'medical home' initiative to improve care coordination for our patients, in addition to exemplary specialty care. This Medicare Shared Savings Plan challenges hospitals and doctors, together with their patients, to reevaluate and redesign patient care to be more patient-centered and efficient — across all care settings, including at home."

The recent announcement was the culmination of a comprehensive selection process that began in the fall of 2011 with the national release by CMS of the Notice of Intent to Apply and application form. The UCLA Health was selected based on vigorous eligibility criteria and program requirements.

"We have a successful primary care network," said Dr. Patricia Kapur, CEO of the UCLA Faculty Practice Group. "The framework we currently have in place provides us with a perfect opportunity to work with the federal government's Shared Savings Program to transform the delivery of excellent medical care."

The Shared Savings Program is not a Medicare Advantage plan or an HMO. Beneficiaries with fee-for-service Medicare will still have the right to use any doctor or hospital that accepts Medicare, at any time. Find out more(Link is external) about the Shared Savings Program and see a list(Link is external) of the program's 106 new ACOs announced Jan. 10.

The UCLA Health will continue to serve all Medicare fee-for-service beneficiaries, including those in the Medicare Shared Savings Program. The program will support UCLA's efforts to improve the quality of care it provides, in return for the opportunity to benefit from reduced growth in health care costs.

The UCLA Health(Link is external), which comprises the UCLA Hospital System and the UCLA Medical Group and its affiliates, has provided a high quality of health care and the most advanced treatment options to the people of Los Angeles and the world for more than half a century. Ronald Reagan UCLA Medical Center, the Resnick Neuropsychiatric Hospital at UCLA, UCLA Mattel Children's Hospital, and UCLA Health - Santa Monica Medical Center (which includes the Los Angeles Orthopaedic Hospital) deliver hospital care that is unparalleled in California. Ronald Reagan UCLA Medical Center is consistently ranked one of the top five hospitals in the nation and the best in the western United States by U.S. News & World Report. UCLA physicians and hospitals continue to be world leaders in the full range of care, from maintaining the health of families to the diagnosis and treatment of complex illnesses.