Bellin-Thedacare Healthcare Partners - CMS Pioneer ACO

Program Location: 
Green Bay, WI
Payer Type: 
Medicare
Parent Program: 
Payers: 
Medicare

Reported Outcomes

Description: 

Bellin Health, ThedaCare and a network of nearly 700 physicians are participating in an innovative Medicare pilot payment program designed to improve healthcare services for patients in Northeast Wisconsin. 

The Pioneer ACO  program will improve patient care and control the per capita cost of healthcare. To achieve these goals, the doctors and medical staff will work together to develop the right tools, personnel, and management competencies across each individual patient’s care needs. 

The ACO model defines a group of individuals – in this case, Medicare patients whose providers have an affiliation with Bellin Health-ThedaCare Healthcare Partners – and part of the payment to the healthcare organization is based on achievement of specific goals including process measures, clinical outcomes and patient satisfaction scores.

The model is designed to work in coordination with private insurance companies and employers with the goal of saving money while improving care quality and outcomes.

Payment Model: 

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.

Cost Savings: 
  •  reduced the cost of care by 4.6% for about 20,000 Medicare beneficiaries in northeast Wisconsin in 2012
Last updated September 2018
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