IU Health Accountable Care Organization (ACO)

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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. Additionally, patients can receive acute care treatment at urgent care facilities aligned with Indiana University Health ACO, Inc. Search for an IU Health Urgent Care location close to you.

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.

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.

Indiana University Health ACO, Inc.

IU Health ACO: 317.963.5522 or iuhealthaco@iuhealth.org.

Centers for Medicare and Medicaid Services (CMS): 800.633.4227 (TTY 877.486.2048)

Indiana University Health ACO, Inc.,
340 West 10th Street, Indianapolis, IN 46202

Hours: Monday-Friday, 8am-5pm

Primary Contact: Victoria Bratcher, Director of ACO Operations

Organizational Information

Indiana University Health ACO, Inc.’s Participant Entities

  • Arnett Clinic, LLC
  • IU Health Physicians
  • IU Health Ball Memorial Physicians, Inc.
  • IU Health Bedford Physicians, LLC
  • IU Health Morgan Physicians, LLC
  • IU Health Southern Indiana Physicians, Inc.
  • IU Health Bloomington, Inc.
  • IU Health Paoli, Inc.
  • Orthopedics of South Central Indiana, LLC
  • Southern Indiana Pediatrics, LLC
  • Union Hospital, Inc.
  • Union Associated Physicians Clinic, LLC
  • Providence Medical Group, LLC

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

  • Altenheim Health and Living, Indianapolis, IN
  • American Village, Indianapolis, IN
  • Arbor Trace, Richmond, IN
  • Aspen Trace, Greenwood, IN
  • Bell Trace, Bloomington, IN
  • Brookside Village, Jasper, IN
  • Brown County Health and Living Community, Nashville, IN
  • Brownsburg Meadows, Brownsburg, IN
  • Clinton Gardens, Clinton , IN
  • Copper Trace Health and Living, Carmel, IN
  • Cumberland Trace, Plainfield, IN
  • Greenwood Health and Living, Greenwood, IN
  • Meadow Manor North, Terre Haute, IN
  • Miller's Merry Manor - Indy East, Indianapolis, IN
  • Miller's Merry Manor - Sullivan, Sullivan, IN
  • Miller's Merry Manor - Tipton, Tipton, IN
  • Mulberry Health and Rehabilitation Center, Mulberry, IN
  • Northwest Manor Health Care Center, Indianapolis, IN
  • Providence Health Care Center, St. Mary-Of-The-Woods, IN
  • Springhill Village, Terre Haute, IN
  • St. Anthony Rehabilitation and Nursing Center, Lafayette, IN
  • Westminster Village Health and Rehab, Terre Haute, IN
  • Westminster Village West, West Lafayette, IN
  • Westview Nursing and Rehabilitation Center, Bedford, IN

    Indiana University Health ACO, Inc.’s Governing Body

    • Ron Stiver
      • Voting Member and Chair, Indiana University Health, Inc.
    • Greg Kiray, M.D.
      • Voting Member, Indiana University Health Physicians, Inc.
    • Jeff Bird, M.D.
      • Voting Member, Ball Memorial Physicians, Inc.
    • Hans Andreasen, M.D.
      • Voting Member, Union Associated Physicians Clinic, LLC
    • Judith Palmer
      • Voting Member, Consumer Advocate
    • Dan Handel, M.D.
      • Voting Member, IU Health Southern Indiana Physicians, Inc.
    • Johnnie Ayers, M.D.
      • Voting Member, Medicare Beneficiary Representative

    Key Clinical and Administrative Leadership (all employed by Indiana University Health, Inc.)

    • Greg Kiray, M.D., Chief Executive Officer of IU Health ACO, Inc. & SVP of Population Health
    • Roxanne Binford, ACO Chief Compliance Officer
    • Mike Resener, General Counsel
    • Rick Bernhardt, M.D., Medical Director
    • Tori Bratcher, Director of ACO & Population Health Operations
    • Jerry Bradford, IU Health Plans and Population Health Chief Financial Officer
    • Lauren Sweeny, ACO Manager
    • 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

    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

    Indiana University Health ACO, Inc.'s Participants

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

    The Indiana University Health ACO is eligible to use the 3-Day Skilled Nursing Facility Waiver, Telehealth Waiver, and Cost Sharing Support for Part B Services 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

    Indiana University Health ACO, Inc. (“IUHACO”) is currently participating in the Next Generation ACO Model (“NGACO”) pursuant to a Participation Agreement with the Centers for Medicare & Medicaid Services (“CMS”) initially entered into effective January 1, 2017, and renewed effective January 1, 2019 for a successive two-year term. The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain fraud and abuse laws that otherwise limit innovation by Accountable Care Organizations (“ACO Waivers”). The ACO Waivers provide for a waiver of federal fraud and abuse laws for arrangements entered into by an NGACO that are reasonably related to the purposes of the NGACO (the “NGACO Participation Waiver”).

    In order to receive the benefit and protection of the NGACO Participation Waiver, the Board of Directors of IUHACO, after discussion and deliberation, has made a bona fide determination that the following Arrangement (“Arrangement”) is reasonably related to the purpose of the IUHACO NGACO, and is publicly disclosing the Arrangement in accordance with the requirements of the NGACO Participation Waiver.

    IUHACO has worked with Indiana University Health Physicians to develop IUHP Connected Care at Saxony (“Connected Care Clinic”). The effective date of the initiation of the Connected Care Clinic is January 1, 2020. The Connected Care Clinic is an alternative care model that allows healthcare and other providers to focus on IUHACO NGACO beneficiaries and other value based care members. The Connected Care Clinic is a move away from a volume based care model to a care model based on providing additional care management resources to support the reduction of the cost of health care through better coordination of care, more robust chronic disease management and improved quality of care. The Board of Directors of IUHACO has made a bona fide determination that the Connected Care Clinic is reasonably related to and meets the purposes of the NGACO by providing resources to provide better care for individuals, better health outcomes, reducing the cost of healthcare and improving the work life balance of healthcare providers and staff.

    Future arrangements, and modifications to current arrangements, will be disclosed in accordance with CMS requirements.

    The Indiana University Health ACO does not have any joint ventures with Next Generation ACO Participant Providers or Preferred Providers to disclose.

    Waiver Disclosures

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

    The Indiana University Health ACO is eligible to use the 3-Day Skilled Nursing Facility Waiver, Telehealth Waiver, and Cost Sharing Support for Part B Services 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

    Indiana University Health ACO, Inc. (“IUHACO”) is currently participating in the Next Generation ACO Model (“NGACO”) pursuant to a Participation Agreement with the Centers for Medicare & Medicaid Services (“CMS”) initially entered into effective January 1, 2017, and renewed effective January 1, 2019 for a successive two-year term. The Secretary of the U.S. Department of Health and Human Services has provided waivers of certain fraud and abuse laws that otherwise limit innovation by Accountable Care Organizations (“ACO Waivers”). The ACO Waivers provide for a waiver of federal fraud and abuse laws for arrangements entered into by an NGACO that are reasonably related to the purposes of the NGACO (the “NGACO Participation Waiver”).

    In order to receive the benefit and protection of the NGACO Participation Waiver, the Board of Directors of IUHACO, after discussion and deliberation, has made a bona fide determination that the following Arrangement (“Arrangement”) is reasonably related to the purpose of the IUHACO NGACO, and is publicly disclosing the Arrangement in accordance with the requirements of the NGACO Participation Waiver.

    IUHACO has worked with Indiana University Health Physicians to develop IUHP Connected Care at Saxony (“Connected Care Clinic”). The effective date of the initiation of the Connected Care Clinic is January 1, 2020. The Connected Care Clinic is an alternative care model that allows healthcare and other providers to focus on IUHACO NGACO beneficiaries and other value based care members. The Connected Care Clinic is a move away from a volume based care model to a care model based on providing additional care management resources to support the reduction of the cost of health care through better coordination of care, more robust chronic disease management and improved quality of care. The Board of Directors of IUHACO has made a bona fide determination that the Connected Care Clinic is reasonably related to and meets the purposes of the NGACO by providing resources to provide better care for individuals, better health outcomes, reducing the cost of healthcare and improving the work life balance of healthcare providers and staff.

    Future arrangements, and modifications to current arrangements, will be disclosed in accordance with CMS requirements.

    The Indiana University Health ACO does not have any joint ventures with Next Generation ACO Participant Providers or Preferred Providers to disclose.