Heritage California ACO is operated by the Heritage Provider Network (HPN) family of organizations which is comprised of Heritage Provider Network, Inc. and its ten affiliated Medical Groups and Independent Physician Associations. Through the Pioneer ACO Model, HCACO will work with CMS to provide Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination.
As one in a diverse group of leading-edge health care organizations from around the country, HPN was chosen specifically by the Innovation Center to test the effectiveness of several models of payment in helping organizations make a rapid transition to higher quality care at a lower cost to Medicare. Heritage California ACO will use this model to demonstrate that a fully integrated patient-focused, physician-directed and care coordinated program will improve quality and reduce healthcare per capita spending.
The payment models being tested in the first two years of the Pioneer ACO Model are a shared savings payment policy with generally higher levels of shared savings and risk for Pioneer ACOs than levels currently proposed in the Medicare Shared Savings Program. In year three of the program, participating ACOs that have shown a specified level of savings over the first two years will be eligible to move a substantial portion of their payments to a population-based model. These models of payments will also be flexible to accommodate the specific organizational and market conditions in which Pioneer ACOs work.
