Brown & Toland Physicians - CMS Pioneer ACO

Program Location: 
San Francisco, CA
Payer Type: 
Medicare
Parent Program: 
Payers: 
Medicare

Reported Outcomes

Description: 

Through the Pioneer ACO Model, Brown & Toland Physicians will work with CMS to provide Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination. Currently, about 190 physicians, located in San Francisco and the East Bay, are providing care for the more than 18,000 Medicare beneficiaries in Brown & Toland's Pioneer ACO. In addition to the physicians, Brown & Toland's Care Management team of registered nurses, social workers and other healthcare professionals provide additional services and care for these patients. 

Brown & Toland's ACO program offers the following services at no additional cost to Medicare ACO beneficiaries:

  • More comprehensive, coordinated, and seamless care between doctors and specialists and other health care providers
  • Post-hospitalization or discharge assistance, such as home visits from a trained patient advocate, to help Medicare ACO beneficiaries connect with their doctor, help them understand their medications, or set up additional services they may need
  • Chronic disease care instruction and educational programs for patients and their caregivers 
  • Health coaches and patient advocates to help the patient access follow-up health care services
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: 
  • helped save Medicare $4.5 Million 
  • 1 of 11 CMS Pioneer ACOs to earn shared savings
Last updated September 2018
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