UCLA Health is participating in a Medicare program that will reduce costs and improve patient care.
Under the Medicare Shared Savings Program, UCLA Health will be able to improve patient care and therefore reduce the number of visits necessary for patients with chronic illnesses. MSSP, which includes several other health organizations, requires the participating health care providers to share patient data so the health organizations can better coordinate their care.
MSSP, established as part of the Affordable Care Act, rewards health care systems for improving their efficiency and making health care more affordable for their patients.
Previously, Medicare reimbursed UCLA Health’s costs of services to patients. Under MSSP, the number Medicare reimbursements to UCLA Health may fluctuate year to year depending on how successfully they improve patient care.
UCLA Health began to collect and share patient and physician data Jan. 1, which will affect how much the health system will be reimbursed in 2019.
Under MSSP, Accountable Care Organizations, which are made up of groups of physicians and health care providers, share patient data and are able to more effectively coordinate patient care.
Accountable Care Organizations, including UCLA Health, helped save more than $14.5 million in 2014, according to an Anthem Blue Cross press release.
MSSP was introduced by the Medicare Access and CHIP Reauthorization Act, a provision under the Affordable Care Act.
UCLA is making the MACRA changes in tandem with the Institute for Healthcare Improvement’s Triple Aim program, which was established to improve patients’ health care experience, improve the health of general populations and reduce the per capita cost of care, according to the program website.
“What we’ve also done is added case coordinators who are unlicensed professionals who develop a care plan for patients,” said Joyce Komori, the UCLA Health Accountable Care Organization’s primary contact. “You could call it a concierge service for high-use patients.”
Komori said UCLA has a focus on providing primary care physician services.
“The Primary Care Provider can be like a gatekeeper, so when a patient checks in the PCP can direct them to a specialty provider,” Komori said.
Patients can opt out of sharing personal health information with the ACO, according to the UCLA Health website.
It is unclear how ACOs would be affected if the Trump administration modifies the Affordable Care Act, according to NPR.