DWEB-CMS2B
About Mercy

Medicare Shared Savings Program

In July 2012, Mercy ACO became a recognized Accountable Care Organization under the Medicare Shared Savings Program. With the program’s focus of improved quality of care and increased patient value, the shared savings program was logical next step in the evolution of Mercy’s health care model. The Medicare Shared Savings Program further aligns incentives to providing quality health care, increased patient satisfaction and lower cost for this patient population.

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The Mercy ACO Board of Managers (BOM) has made and duly authorized a bona fide determination that the following arrangements are reasonably related to the purposes of the Medicare Shared Savings Program. The following disclosures invoke the ACO Participation Waiver as set forth by CMS and OIG:

  • Population Health Management and Risk Management System. This is a data registry to track billing and clinical information of Mercy ACO’s patient population. The data registry allows Mercy ACO to identify patients with care opportunities and to monitor the quality performance of ACO Participants and eligible Outside Parties. Mercy ACO and the data registry Vendor provide support to integrate data from ACO Participants’ and eligible Outside Parties’ systems to the data registry, in addition to user access to the system. This includes the development of computer interfaces and dashboard interfaces for ACO Participants and eligible Outside Parties. This arrangement provides transparency and promotes accountability for the quality and overall care of Mercy ACO-assigned Medicare beneficiaries, which assists Mercy ACO in improving and meeting quality performance standards of the Medicare Shared Savings Program. Approved by the Mercy ACO BOM on May 6, 2016.
     
  • Care Management Platform. This IT system is used to standardize, document, and track care management interventions. This system allows Mercy ACO to coordinate the care of Mercy ACO’s patient population by connecting ACO Participants and eligible Outside Parties on one care management platform. Mercy ACO and the system Vendor provide user access of the Care Management Platform to ACO Participants and eligible Outside Parties. This arrangement allows for greater care coordination of Mercy ACO-assigned Medicare beneficiaries between ACO Participants and eligible Outside, which assists Mercy ACO in improving and meeting quality performance standards of the Medicare Shared Savings Program. Approved by the Mercy ACO BOM on Sept. 10, 2014. 
     
  • Health Coaches. RN Health Coaches proactively intervene with Mercy ACO’s patient population to assist in behavioral change to meet health and life goals. Health Coaches allow Mercy ACO to deliver the Mercy ACO health coach program at the ACO Participant and eligible Outside Party-level. Mercy ACO provides Health Coach services in primary care and acute care settings to ACO Participants and eligible Outside Parties. This arrangement allows for greater care coordination, including post-discharge follow-up and preventative care services, of Mercy ACO-assigned Medicare beneficiaries, which assists Mercy ACO in improving and meeting quality performance standards of the Medicare Shared Savings Program. Approved by the Mercy ACO BOM on Sept. 10, 2014. 
     
  • Health Coach Training. This is a training program designed to optimize the health and well-being of Mercy ACO’s patient population. This training allows Mercy ACO to educate RN Health Coaches on foundations of patient-centric care and techniques for behavioral change for improved care delivery at the ACO Participant and eligible Outside Party-level. Mercy ACO provides training for all new Health Coaches and on-going training for all established Health Coaches that work at the ACO Participant and eligible Outside Party-level. This arrangement leads to improved quality and overall care of Mercy ACO-assigned Medicare beneficiaries, which assists Mercy ACO in improving and meeting quality performance standards of the Medicare Shared Savings Program. Approved by the Mercy ACO BOM on May 5, 2015.
     
  • Mercy Portal. This Integration Platform is used for clinically-integrated network (CIN) collaboration and secure distribution of datasets as it relates to Mercy ACO’s patient population. This platform allows Mercy ACO to collaborate with ACO Participants and eligible Outside Parties on operational, financial and clinical improvement activities by integrating multiple applications on one, secure platform. Mercy ACO provides user access of the Mercy Portal to ACO Participants and eligible Outside Parties. This arrangement allows for greater coordination and standardization of care delivery for Mercy ACO-assigned Medicare beneficiaries, which assists Mercy ACO in improving and meeting quality performance standards of the Medicare Shared Savings Program. Approved by the Mercy ACO BOM on May 6, 2016.

     

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