Pioneer: Foot soldier detailed to make roads, dig entrenchments, etc., in advance of the main body.

As a top performer in Year 1 of the CMS Pioneer ACO program, Monarch HealthCare is paving the way to accountable care with a foundation of patient- and provider-centered strategies that support Triple Aim goals.

The California IPA's population disease profile, targeted patient engagement strategy, arsenal of health management tools and multidisciplinary ACO clinical team are just a few innovations on Monarch's accountable care frontier.

Tactics from a Top-Performing Pioneer ACO: Engaging Patients and Providers in Accountable Care provides first-year advice from Monarch HealthCare's Medicare accountable care organization, one of 32 original CMS Pioneer ACOs engaged to test alternative payment and program design models for accountable care organizations.

Colin LeClair, executive director of ACO for Monarch HealthCare, recounts in this 30-page resource the challenges, results and learnings from its first 12 months as a Pioneer ACO, including the IPA's interest in redefining care coordination boundaries. LeClair also shares Monarch's year 2 and 3 Pioneer ACO strategies as well as expectations from its continued commitment to accountable care for Medicare beneficiaries.

Monarch HealthCare is one of 23 remaining Pioneer ACOs.

LeClair provides details on how Monarch:

• Demonstrates the value of the ACO to its members;
• Achieves the highest ACO ROI in terms of quality and cost improvements;
• Coordinates care for ACO patients who utilize non-contracted physicians;
• Developed an effective incentive structure for the Annual Medicare Wellness Visit that leads to actionable data;
• Created a preferred network of cost-effective, high-quality ancillary vendors, including home healthcare, DME and SNFs;
• Used the lessons learned through the Medicare Pioneer ACO program to continue to expand its organizational participation in other ACOs and other performance-based contracts; and
• Will amp up efforts to engage providers, patients and support staff in the Pioneer ACO via incentives.

Tactics from a Top-Performing Pioneer ACO: Engaging Patients and Providers in Accountable Care goes on to answer more than 15 questions related to first-year operations and results from this survivor Pioneer ACO, the largest IPA in Orange County, California.

Table of Contents

• Success Strategies for Medicare Pioneer ACOs
  • Motivations for Monarch Pioneer ACO Participation
  • Developing Population Disease Profile
  • 3 Opportunities to Improve Patient Engagement
  • Engaging Monarch Physicians in Pioneer ACO
  • 4 Drivers of Performance Year 1 Results
  • Physician Tools
  • 5 Lessons Learned
  • Future Evolution of ACO Strategy
• Q&A: Ask the Experts
  • Challenges of Beating CMS Pioneer ACO Benchmarks
  • Monarch's Care Coordination Service
  • Year 2 Priorities for Monarch Pioneer ACO
  • Reducing Readmissions for CHF and COPD Patients
  • Reflections on the Year One Experience
  • Predictions for Continued Shared Savings
  • Care Coordination for Out-of-Network Patients
  • Improving Completion of Medicare Senior Health Assessment
  • Populations Meriting Home Visits
  • Criteria for Top-Performing Physicians
  • Leveraging Pioneer Participation in Other ACOs
  • Communicating Physician ACO Endorsement to Patients
  • Incentives for ACO Office Staff
  • ACO Administrative Costs
  • Implications of the Three-Day Inpatient Waiver
  • Incentives for Patients
• Glossary
• For More Information
• About the Speaker