After establishing an accountable care organization (ACO) in 2012, WESTMED, a large multispecialty group medical practice in Westchester County, N.Y., has improved on nine of 10 health quality metrics, increased patient satisfaction, and reduced healthcare costs, according to officials.
The ACO—which partners WESTMED with UnitedHealthcare and Golden Valley, Minn.-based Optum—has seen significant improvements in patients taking their prescription medications properly; and for diabetics, more routine screening and better control of blood sugar levels.
The ACO is performing above the 90th percentile of National Committee for Quality Assurance (NCQA) Quality Compass for providing the highest level of coordinated care for breast cancer and cervical cancer screenings. Its patient-centered medical home (PCMH) program already had received the highest level of recognition (Level 3) from NCQA for providing coordinated, efficient and quality primary care, officials say.
WESTMED received a nearly $1 million bonus under its ACO agreement with UnitedHealthcare by reducing practice variation, decreasing duplications in care, and promoting the proper setting for care. Participating physicians who met both care quality and cost metrics focusing on providing the right level of care for patients may be eligible for bonuses.
More than 13,000 UnitedHealthcare plan participants who reside in Westchester County and are covered under an Oxford Health fully insured commercial plan were part of the initial ACO collaboration. WESTMED and UnitedHealthcare will expand the ACO program to measure a greater number of metrics, and increase the number of plan participants in this program, including Westchester County-based UnitedHealthcare fully insured plan participants in the coming year.
