Indiana University Health Accountable Care Organization (ACO)

Indiana University Health Accountable Care Organization (ACO)

What is an ACO?

An Accountable Care Organization (ACO) is a group of doctors and other healthcare providers who agree to work together with Medicare to give you the best possible care. ACOs may take different approaches to giving you coordinated care. Some ACOs may have special nurses that help you set up appointments or make sure your medications are in order when you enter or leave a hospital. Other ACOs may help your doctors get you equipment for monitoring your medical conditions better at home, if you need it. Most ACOs use advanced systems that let them more carefully track your care, and make sure your doctor has the most up-to-date information about your health.

The goal of the ACO is to support your doctor in caring for you. ACOs help your doctor and healthcare providers work together more closely, by making sure they have the most up-to-date information about your health and your care. For you, this means your doctors communicate better with each other, and you avoid having duplicate tests or answering the same questions over and over. Working together, your doctors can do more to follow your health, make sure you get the best possible care, and may hire additional staff to help meet your unique care needs, depending on what works best for you.

Doctors and other healthcare providers choose to participate in an ACO because they’re committed to your care experience. They may also be rewarded for offering you better, more coordinated care. If your physician is part of the Indiana University Health ACO, you will be notified, either in person or by letter.

An ACO isn’t the same as a Medicare Advantage Plan or Health Maintenance Organization (HMO). You’re still in Original Medicare, and your Medicare benefits, services, rights and protections won’t change. And you still have the right to use any doctor or hospital that accepts Medicare at any time, the same way you do now.

Next Generation Accountable Care Organization Model Details

The Next Generation ACO Model is an initiative for ACOs that are experienced in coordinating care for populations of patients. The goal of the Model is to test whether strong financial incentives for ACOs, coupled with tools to support better patient engagement and care management, can improve health outcomes and lower expenditures for Original Medicare fee-for-service (FFS) beneficiaries. 

Included in the Next Generation ACO Model are strong patient protections to ensure that patients have access to and receive high-quality care. Like other Medicare ACO initiatives, this Model will be evaluated on its ability to deliver better care for individuals, better health for populations, and lower growth in expenditures.

This is in accordance with the Department of Health and Human Services’ “Better, Smarter, Healthier” approach to improving our nation’s health care and setting clear, measurable goals and a timeline to move the Medicare program―and the health care system at large―toward paying providers based on the quality rather than the quantity of care they provide to patients. In addition, CMS will publicly report the performance of the Next Generation Pioneer ACOs on quality metrics, including patient experience ratings, on its website.

Contact

Indiana University Health ACO, Inc.

ACO Name and Location:

  • Indiana University Health ACO, Inc., 340 West 10th Street, Indianapolis, IN 46202
  • Hours: Monday-Friday, 8am-5pm

Organizational Information

Indiana University Health ACO, Inc.’s Participant Entities

  • Arnett Clinic, LLC
  • IU Health Physicians
  • IU Health Ball Memorial Physicians
  • IU Health Bedford Physicians, LLC
  • Indiana University Health Southern Indiana Physicians, Inc.
  • Indiana University Health Bloomington, Inc.
  • Orthopedics of South Central Indiana, LLC
  • IU Health Morgan Physicians, LLC
  • Southern Indiana Pediatrics, LLC
  • Central Indiana Cancer Center

Indiana University Health ACO, Inc.'s Participants

Indiana University Health ACO, Inc.’s Preferred Providers Eligible to use 3-Day Rule Waiver

  • Allisonville Meadows, Fishers
  • Altenheim Health and Living, Indianapolis
  • American Village, Indianapolis
  • Arbor Trace, Richmond
  • Aspen Trace, Greenwood
  • Beech Grove Meadows, Beech Grove
  • Bell Trace, Bloomington
  • Brookside Village, Jasper
  • Brown County Health and Living, Nashville
  • Brownsburg Meadows, Brownsburg
  • Community Nursing and Rehab Center, Indianapolis
  • Copper Trace, Carmel
  • Covered Bridge Health Campus, Seymour
  • Cumberland Trace, Plainfield
  • Eagle Valley Meadows, Indianapolis
  • Forest Creek Village, Indianapolis
  • Greenwood Health and Living, Greenwood
  • Hamilton Trace, Fishers
  • Lyons Health and Living, Lyons
  • Miller’s Merry Manor, Chesterfield
  • Miller’s Merry Manor, Indianapolis
  • Miller’s Merry Manor, Mooresville
  • Miller’s Merry Manor, Peru
  • Miller’s Merry Manor, Wabash
  • Morristown Manor, Morristown
  • North Capitol Nursing & Rehabilitation, Indianapolis
  • North Woods Village, Kokomo
  • Northwest Manor Health Care Center, Indianapolis
  • Rawlins House, Pendleton
  • Rosewalk Village, Indianapolis
  • St. Anthony Healthcare, Lafayette
  • University Heights Health and Living, Indianapolis
  • University Nursing Center, Upland
  • Westminster Village West, West Lafayette

Indiana University Health ACO, Inc.’s Governing Body

  • John F. Fitzgerald, M.D.
    • Voting Member and Chair, Indiana University Health Physicians, Inc. 
  • Ryan Kitchell
    • Voting Member, Indiana University Health, Inc.
  • Michael Ober, M.D.
    • Voting Member, Indiana University Health Physicians, Inc.
  • Don Clayton, M.D.
    • Voting Member Arnett Clinic, LLC
  • Medicare Beneficiary & Consumer Advocate – Vacant due to resignation July 25, 2017

Key Clinical and Administrative Leadership

  • John F. Fitzgerald, M.D., CEO
    • Indiana University Health Physicians, Inc.
  • Michael Jackson, Chief Compliance Officer
    • Indiana University Health, Inc.
  • Susan Mann, General Counsel
    • Indiana University Health, Inc.
  • Rick Bernhardt, MD, Medical Director
    • Indiana University Health Physicians, Inc.

Types of ACO participants, or combination of participants, that formed the ACO

  • ACO Professionals in a group practice arrangement
  • Network of individual practices of ACO professionals
  • Partnership or joint venture arrangements between hospitals and ACO professionals
    • No such partnerships or joint ventures exist at this time
  • Hospital employing ACO professionals

Information Related to Indiana University Health ACO, Inc.’s Qualification for Next Generation ACO Model Pre-Participation and Participation Waivers

Indiana University Health ACO is eligible to use the 3-Day Skilled Nursing Facility Waiver, Telehealth Waiver and the Post-Discharge Home Visit Waiver.

The Board of Directors for Indiana University Health ACO, Inc. (“IU Health ACO”) has approved execution of a Memorandum of Understanding Regarding Contribution of Support Services by and among IU Health ACO and Indiana University Health, Inc. (“IU Health”) and Indiana University Health Care Associates, Inc. d/b/a IU Health Physicians (“IU Health Physicians”). In order to assist IU Health ACO in its pursuit of the Next Generation ACO Model’s three-part aim of (1) better care for individuals, (2) better health for populations, and (3) lower growth in Medicare Parts A and B expenditures, IU Health and IU Health Physicians have agreed to provide certain support services to IU Health ACO for startup and ongoing operations of IU Health ACO. The support services include:

  • Personnel resources
  • Information technology resources
  • Patient communication media, including patient notifications, printings and mailings, website development, call center training, Service Excellence training, and facilities signage