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Success of Government’s ACO Pilot Could Mean Changes in Medicare Shared Savings Program Avoiding a Merger: Hospitals Affiliate to Gain Benefits While Maintaining Independence Three Pillars of Success in Practice Mergers
April 2015
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C O N T E N T S
Success of Government’s ACO Pilot Could Mean Changes in Medicare Shared Savings CONTENTS
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Avoiding a Merger: Hospitals Affiliate to Gain Benefits While Maintaining Independence
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Three Pillars of Success in Practice Mergers
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Affordable Care Act Payment Model Saves More Than $384 Million in Two Years, Meets Criteria for First-Ever Expansion
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Capital is Latest to React to Health Care’s Growing Emphasis on Patient Outcomes
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Capital’s Center for Women’s Health Achieves ‘Patient-Centered Medical Home’ Status
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Cigna, Oncology Group Join Forces in Value-Based Care Program
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Chrysalis Medical Services Selects New Partner
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Health Care Consulting Firm Laying Off 88 Workers
4 Affiliated Practice
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Cover Story
Success of Government’s Aco Pilot Could Mean Changes in Medicare Shared Savings Program By Beth Fitzgerald
The federal government said Monday that its innovative Medicare pilot, the Pioneer Accountable Care Organization, has both saved money and delivered high-quality care, and that elements of Pioneer will be incorporated into the larger Medicare shared savings ACO program that now involves more than 400 health care organizations in the U.S., including more than a dozen in New Jersey. Dr. Patrick Conway, acting principal deputy administrator for the Centers for Medicare and Medicaid Services, told reporters during a conference call that, based on the success of Pioneer, CMS wants Medicare ACOs to assume two-sided risk: as with Pioneer, health care providers would have the chance to share in a higher percentage of the savings that Medicare realizes form an ACO, but would also have to pay back some revenue to Medicare if those savings don’t pan out. Conway said that, of the 32 original Pioneer ACOs, 13 dropped out of the program, and two had to make repayments to Medicare. None of the Pioneer ACOs is in New Jersey. CMS said Monday that an independent evaluation concluded that Pioneer generated over $384 million in savings to Medicare over its first two years, in 2012 and 2013, or an average of $300 per participating beneficiary per year — while continuing to deliver high-quality patient care. Conway said the Pioneer ACOs provide coordinated medical care that helps keep Medicare members out of the hospital, as well as reducing hospital readmissions. “This is big news,” said Joel Cantor, director of the Rutgers Center for State Health Policy. “The ACA created authority for the federal government to widely adopt innovations that reduce costs and improve care, and this model is the first to meet that test.” Cantor said, “Health care providers today face a barrage of performance incentives from different programs and insurers, and the success of the Pioneer model suggests that performance can improve more when providers operate under a single set of clear incentives.” CMS said that, so far, the broader Medicare ACO shared savings program has generated over $417 million in total savings for Medicare. Three New Jersey Medicare ACOs have so far saved Medicare money, and shared in those savings: Optimus Healthcare Partners, which includes more than 500 physicians and the hospital system Atlantic Health; Meridian ACO, which is affiliated with Meridian Health; and Hackensack Physician-Hospital Alliance ACO, which is affiliated with the Hackensack University Health Network. Jeff Brown, executive director of the QI Collaborative at the New Jersey Health Care Quality Institute, pointed out that, unlike the standard Medicare shared saving model, the Pioneer ACO providers had to agree to bear substantial financial risk to participate. “Thus, if they are unable to control costs, they can end up owing more money to CMS. Successful Pioneer ACOs have shown to be adept at advanced population health management, risk management, and have made the necessary investments in data, information technology and workforce to effectively improve quality and reduce costs.” Brown said: “In terms of expansion of the model, it will be interesting to see how CMS chooses to proceed. They have already incorporated elements of the Pioneer program into their “Next Generation ACO Model,” which was announced in March. He noted that CMS isn’t accepting new applicants into the Pioneer program, and said CMS expects about 15 to 20 Next Generation ACOs nationwide in the first of two rounds of applications. “I think this shows that advanced payment models with substantial provider risk can be highly successful — but the organizations involved must have the right pieces in place to make them work,” Brown said. 6 Affiliated Practice
Health and Human Services Secretary Sylvia M. Burwell said, “The Pioneer ACO model has demonstrated that patients can get high quality and coordinated care at the right time, and we can generate savings for Medicare and the health care system at large.” Conway said this is Year Four of the five-year Pioneer pilot, after which the Pioneer ACOs will likely transition to a retooled Medicare ACO program that incorporates ideas successfully tested by Pioneer. HHS announced in January that it wants to tie 30 percent of Medicare payments to quality and value through alternative payment models like ACOs by 2016, and 50 percent of payments by 2018. Conway said about 7.8 million Medicare members are currently covered by alternative payment programs. Conway said among the Pioneer features that will be extended to the larger Medicare ACO program will be enabling Medicare members to choose their ACO, instead of assigning Medicare members to an ACO in their geographic area. He said this will enable the ACO to “deliver more holistic care. It is an important design element that will help (the ACO) manage their patients and empower patients to make a proactive choice about who their ACO is.”
Avoiding a Merger: Hospitals Affiliate To Gain Benefits While Maintaining Independence By Beth Fitzgerald
H
ospital mergers aren’t the only path to the cost savings and superior patient outcomes demanded by care reform.
Affiliations among hospitals and health care systems, like the one just announced by Englewood Hospital and Medical Center and the Hackensack University Health Network, are becoming a popular way for hospitals to remain independent while tapping the clinical and financial leverage that comes from joining forces with a bigger partner. Warren Geller, chief executive of Englewood, said it was critical for his organization keep its own identity — something the affiliation with Hackensack will accomplish. “We are going to remain independent; it works well for us,” Geller said. “We have a tremendous track record of financial stability and philanthropy, of people supporting our medical center, which is very important to us.” He said both Hackensack and Englewood “are proud of our brands and our cultures.” One thing the affiliation will do is bring Englewood the benefits of the substantial technology investments Hackensack has made in the last few years. Advanced health IT systems are required to track patient care and health outcomes as the industry transitions to a future where it’s expected to keep people healthy, not just treat illnesses and injuries. “When you take the system that Hackensack spent several years building, and we can take the research and expertise that went into that and implement it here at Englewood — there are significant savings in that,” Geller said. Englewood is an academic medical center that trains resident physicians, and Geller said the affiliation will enable his program to grow in tandem with the new medical school Hackensack is launching in partnership with Seton Hall University. — cont’d
April 2015 7
Englewood’s residency program is sponsored by New York’s Mount Sinai School of Medicine; next year, Englewood will switch to Seton Hall University, and the new medical school will be the sponsor following its launch, targeted for 2017. Geller said Englewood has a total of 49 residency slots; 39 are Englewood residents being trained in internal medical, and 10 are residents from other programs who rotate through Englewood as they are trained in emergency medicine, critical care and surgery. He’s optimistic that the affiliation with the new Seton Hall/Hackensack medical school could enable Englewood to get more residency slots “We will look at our needs on our medical staff and see where we need to build, in which specialties, and hopefully develop training programs,” he said. One area could be cardiology, a major program at Englewood. The medical center is building a new 180,000-square-foot cancer center, “so it’s going to make sense for us to train the next generation of experts within all the different areas of oncology.” The health care map of New Jersey is crisscrossed with affiliations — and occasionally they morph into mergers. After working closely together in the AllSpire Health Partners alliance, created in 2013 so hospitals could share best practices, Hackensack and Meridian Health earlier this year announced they will merge into a $3.44 billion health system, the largest in the state. And while Hackensack’s affiliation with Palisades Medical Center led to the merger of Palisades into the Hackensack network earlier this month, Hackensack maintains numerous clinical affiliations that don’t involve mergers. Valley Hospital in Ridgewood in December announced a strategic alliance with New York’s Mount Sinai Health System, a move Valley Chief Executive Audrey Meyers said does not foreshadow an eventual merger of the two institutions. And earlier this month Valley launched a cardiac care affiliation with the Cleveland Clinic, which for the past 20 years has been ranked No. 1 for heart care by U.S. News & World Report. Other affiliations around the state include Cooper University Health System’s 2013 affiliation with Houston’s prestigious MD Anderson Cancer Center. In January, Inspira Health Network in southern New Jersey announced an affiliation with Philadelphia’s Thomas Jefferson University and Health System aimed at increasing specialty health care services to residents in South Jersey. Inspira and Jefferson plan to build a new ambulatory care facility in Gloucester County. Last October, Summit Medical Group, one of the state’s largest multispecialty physician practices, announced an affiliation with MD Anderson in which Summit will build a new outpatient cancer center in Northern New Jersey.
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Earlier this month, Hackensack and Summit Health Management, an affiliate of Summit Medical Group, announced a partnership they predicted will lead to the creation of the largest physician group in the state, with about 1,500 providers. Some health care experts contend hospital mergers drive up health care costs, because larger systems have more clout when negotiating reimbursement rates with health insurers and other payers. In that view, affiliations are a less inflationary alternative. Joel Cantor, director of the Rutgers Center for State Health Policy, said, “Affiliations have lower transaction costs than formal mergers” and “do not necessarily offer the opportunity to expand hospital bargaining leverage with payers.” Cantor said affiliations “offer other advantages, such as enhancing capacity to deliver a broader range of services and creating new branding opportunities when affiliations are with high-prestige institutions,” such as MD Anderson and Cleveland Clinic. And he said affiliations also bring new opportunities for quality and efficiency improvement if the new partners bring new clinical expertise and data and analytic capacity. Cantor said: “Medicare and other payers are moving rapidly into payment systems that reward quality outcomes, as well as efficiencies. I suspect that, together with improved branding, is driving many of these affiliations.” Linda Schwimmer, vice president of the New Jersey Health Care Quality Institute, said, “I think that the trend toward affiliations will increase as hospitals hone in on two current realities: they can’t be all things to all patients in a value-based, outcome-based payment world; and, care will continue to migrate outside the hospital walls.” Schwimmer said: “This trend, in my opinion, is a good thing for patients and payers. Community hospitals will focus on what they are good at (leading to higher quality) and send their patients to centers of excellence for more complex care. These same hospitals are also affiliating with physicians and ancillary health care centers to create stronger community connections and develop a continuum of care, which should lead to improved communications, better outcomes and reduced costs.” And she pointed out that the Federal Trade Commission is keeping close watch on hospital mergers that could reduce competition: “The antitrust watchdogs still cast a suspicious eye at too much regional consolidation and the health systems’ underlying motives. Given the cost of health care, that is a healthy tension.” Englewood was founded 125 years ago and has the financial strength to remain independent; Geller said Englewood, which had revenue of $438.6 million last year, has generated a surplus from operations for the past eight years. “But in the new era of health care, you need to collaborate to participate in advanced systems, in population health management and in training and research,” Geller said. He challenged the view that hospital consolidation inevitably leads to higher medical bills. Geller said Englewood participates in value-based contracts and pay-for-performance contracts “with both penalties and bonuses built in.” Those new payment models “are a small percentage today, but we see that growing rapidly. What you’re going to see is a transition from a transaction-based system to one where you actually get paid for value. This is a new world order that we are embracing, and we’re looking forward to where it’s taking us.” April 2015 9
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10 Affiliated Practice
3 Pillars of Success in Practice Mergers By Austin Kirkland
W
hen medical practices consolidate through a merger or acquisition, they do so today for the same reasons they did 20 years ago. Among them are more favorable call frequency, economies of scale, leverage in contracting, purchasing power, market dominance, volume for new business lines, access to capital and more sophisticated management. Today, however, the stakes and investments are higher and there is tremendous pressure for the newly merged entity to achieve synergies that provide exponential economic and strategic returns. While the returns are realized after the merger, three essentials must exist before the merger to make the returns possible. 1. Physician leadership. The practice cannot exist without a capable physician leader. The identity of medical groups, like most accounting and law firms and other businesses offering personal services, is inseparable from its majority owners who have name recognition outside the group and human capital inside the group. This makes leadership selection and succession planning critical to the long-term viability of the practice. When two groups with their respective physician leaders merge, one inevitably will continue as the practice leader and the other will take a secondary role. Making the merger successful requires the leadership skills of both through the transition and beyond. Medical groups with strong physician leaders can survive and thrive. 2. Stakeholder buy-in. If you are an officer or director in a medical group, you are a stakeholder. If you are a shareholder in a medical group, you are a stakeholder. If you are an employed physician in a medical group, you are a stakeholder. In fact, the stakeholders in the group include the practice manager and all employed staff, as well as financial institutions and other organizations to which the group has contractual obligations or liabilities. Any consultant, accountant or attorney who works in mergers and acquisitions will tell you that getting the buy-in of stakeholders is essential to the success of the merger. While this advice doesn’t prescribe a democratic process where employees must sign off on the deal, it does call for a thoughtful, professional process that includes communication and education beyond the merger committee members well in advance of the merger. The degree to which stakeholders’ expectations are aligned with reality is directly proportional to the success of the merger. 3. Shared culture. When two medical groups merge, they don’t just combine their financial statements. Facilities, equipment, supplies, personnel, schedules, practice patterns and many other elements of the two entities must come together. As difficult as it may be to join the two, the merger of medical groups is made even more complex by the presence of those who are the owners and the means of production – the physicians. Physicians bring to the merger their clinical skill, talent and intellect, a commitment to the profession, and, most often, an excellent work ethic. They also bring with them their egos, strong opinions, unique ideals, and, occasionally, emotional baggage or behavioral issues and an inability to function well with a team. All that they bring is fine as long as they are like-minded in their view of medical practice. If one group is about quality and the other about volume, there is no fit. If one group values employees and the other does not, there is no fit. Neither exceptional physician leadership nor the complete buy-in of all stakeholders can overcome divergent cultures. The corporate culture must be shared from the start. Medical groups considering merger as an option should be mindful of their potential to realize those returns as evidenced by the strength of their physician leadership, the buy-in of the stakeholders and a common culture. With these three essentials, medical practice mergers can deliver returns that are more than the sum of their parts.
April 2015 11
Affordable Care Act Payment Model Saves More Than $384 Million in Two Years, Meets Criteria for First-Ever Expansion Pioneer ACO Model advances quality and value in health care
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oday, an independent evaluation report released by the Department of Health and Human Services showed that an innovative payment model created as a pilot project by the Affordable Care Act generated substantial savings to Medicare in just two years. Additionally, the independent Office of the Actuary in the Centers for Medicare & Medicaid Services (CMS) has certified that this patient care model is the first to meet the stringent criteria for expansion to a larger population of Medicare beneficiaries. The independent evaluation report for CMS found that the Pioneer Accountable Care Organization (ACO) Model generated over $384 million in savings to Medicare over its first two years – an average of approximately $300 per participating beneficiary per year – while continuing to deliver high-quality patient care. The Actuary’s certification that expansion of Pioneer ACOs would reduce net Medicare spending, coupled with Secretary Sylvia Mathews Burwell’s determination that expansion would maintain or improve patient care without limiting coverage or benefits, means that HHS will consider ways to scale the Pioneer ACO Model into other Medicare programs. “This is a crucial milestone in our efforts to build a health care system that delivers better care, spends our health care dollars more wisely, and results in healthier people,” said HHS Secretary Sylvia M. Burwell. “The Affordable Care Act gave us powerful new tools to test better ways to improve patient care and keep communities healthier. The Pioneer ACO Model has demonstrated that patients can get high quality and coordinated care at the right time, and we can generate savings for Medicare and the health care system at large.” The Pioneer ACO Model, one of the first payment models launched by CMS, gives experienced health care organizations accountability for quality and cost outcomes for their Medicare patients. Doctors and hospitals who form Pioneer ACOs can share in savings generated for Medicare if they work to coordinate patient care, keep patients healthy and meet certain quality performance standards, or they may be required to pay a share of any losses generated. Currently, the Pioneer ACO Model is serving more than 600,000 Medicare beneficiaries. According to today’s report, compared to their counterparts in regular fee-for-service or Medicare Advantage plans, Medicare beneficiaries who are in Pioneer ACOs, on average: • Report more timely care and better communication with their providers. • Use inpatient hospital services less and have fewer tests and procedures. • Have more follow-up visits from their providers after hospital discharge. Pioneer ACOs are part of the innovative framework established by the Affordable Care Act to move our health care system toward one that rewards doctors based on the quality, not quantity, of care they give patients. HHS earlier this year announced the ambitious goal of tying 30 percent of Medicare payments to quality and value through alternative payment models by 2016 and 50 percent of payments by 2018. More than 3,600 payers, providers, employers, patients, states, consumer groups, consumers and other partners have registered to participate in the Health Care Payment Learning and Action Network, which was launched to help the entire health care system reach these goals. Pioneer ACOs generated Medicare savings of $279.7 million in 2012 and $104.5 million in 2013. To date, actuarial analyses show that ACOs in the Pioneer ACO Model and the Medicare Shared Savings Program have generated over $417 million in 12 Affiliated Practice
total program savings for Medicare. The primary analyses in the evaluation are also reported in an article published in the Journal of the American Medical Association today. “This success demonstrates that CMS can design and test innovative payment and service delivery models that produce better outcomes for the Medicare program and beneficiaries,” added Patrick Conway, MD, the acting principal deputy administrator of CMS. “This gives CMS greater confidence in scaling elements of the model to benefit people across the nation, and we are working to determine the best strategies for embedding the lessons we have already learned from the Pioneer Model into permanent Medicare programs and our nation’s health system.”
Capital is Latest to React to Health Care’s Growing Emphasis on Patient Outcomes By Beth Fitzgerald
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apital Health has launched a new physician network, led by doctors, where the health system and the doctors will collaborate to position themselves for a future in which they are rewarded for improving the health of the people they serve, while making more efficient use of health care resources. Called the Leading Integrated Network of Clinicians, or LINC, this is what’s known as a “clinically integrated network,” explained David K. Dafilou, who in February came on board as LINC’s chief administrative officer. Trenton-based Capital employs about 160 physicians, and about 800 doctors in the community are affiliated with Capital. Dafilou said these doctors are being invited to join LINC, which will provide them with the support they need to transition from the old “fee-for-service” health care model, where clinicians are simply paid for everything they do, to one where compensation is tied to patient outcomes, quality and avoiding excessive costs and duplicative service. Dafilou said LINC will engage in these new “pay for value” contracts with payers, including government programs like Medicare and Medicaid, private health insurance firms and self-insured employers groups. Capital already has a number of these new value-based arrangements. In January, it launched its Medicare Accountable Care Organization, where the ACO shares in the savings Medicare achieves if the ACO meets quality goals while holding the line on costs. And a number of Capital primary care doctors belong to the Horizon Blue Cross Blue Shield of New Jersey “patient centered medical home” program, and receive incentive payments from the insurer to deliver better-coordinated care to patients.
April 2015 13
He said LINC will provide the care management services, and the data analysis, that those new contacts require. And LINC aims to prepare physicians for a new health care payments world that is rapidly taking hold: “I would anticipate that a large majority of our business will be tied into an ‘alternative payment model’ in the next three to four years,” Dafilou said. Capital said LINC is a partnership between physicians and the health system “that is collectively committed to improving the quality and efficiency of care delivered to patients across the continuum of care.” To that end, Dafilou explained that physicians will be working together to develop approaches to clinical care that maximize quality while avoiding waste. LINC will gather clinical data and report that information to the doctors, “so we’re not just saying to the physicians, ‘you’re not delivering a high level of care’ but we tell them where the breakdowns are and where we can make improvements.” The key is the leadership and involvement of the physicians, who will collaborate to advance best practices. He gave the example of orthopedics, where a new payment model might provide the surgeon with a flat or bundled payment for the entire procedure. “It creates an incentive for the physician to care that they are using the most appropriate implant, and that the cost is reasonable.” When patients are discharged from the hospital, perhaps to a skilled nursing facility or back home, LINC care managers will work with the primary care physicians to make sure there is continuity of care: that the patients keep up their medications and have a follow-up visit to the doctor. Without that coordination, it’s more likely patients will be readmitted to the hospital, and “We need to make sure that doesn’t happen,” Dafilou said. Medicare is already penalizing hospitals for excessive readmissions, and new value-based contracts with commercial insurers could include avoiding excessive readmissions as a quality metric. With the care management provided by LINC, “We are going to try to make life easier for physicians by providing some support services so it’s not all on the back of the physicians.” About three-quarters of the board of managers will be physicians, Dafilou said. Dafilou said the move to value-based contracting is being led by Medicare. In January, Medicare announced a goal of tying 30 percent of traditional, or fee-for-service, Medicare payments to quality or value by the end of 2016. Medicare also set a goal of tying 50 percent of payments to these models by the end of 2018. Medicare said that, in 2011, it made almost no payments to providers through alternative payment models — which now represent approximately 20 percent of Medicare payments. Dafilou noted that commercial payers typically follow Medicare’s lead. LINC will also prepare its doctors for the upside potential of the financial incentives offered by new payment models, by developing a methodology for distributing the shared savings payments to providers, Dafilou said. “So let’s say we are successful in these shared savings agreements, and Medicare or Horizon cuts us check: LINC will need to come up with a fair and equitable way to distribute that to the providers.”
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Capital’s Center for Women’s Health Achieves ‘Patient-Centered Medical Home’ Status By Beth Fitzgerald
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apital Health said its Center for Women’s Health has been recognized as a “patient-centered medical home” that uses evidence-based, patient-centered approaches that seek to coordinate patient care in a long-term partnership between patients and clinicians. The PCMH recognition is awarded to medical practices nationwide by the nonprofit National Committee for Quality Assurance. Dr. Randi Protter, medical director of the center in Hamilton, was an NJBIZ Healthcare Heroes finalist last year. The center has three physicians and a nurse practitioner. “Our patients know that, when they come to the Capital Health Center for Women’s Health, they will have a very different type of health care visit,” Protter said. “We view our patients as full partners in their own health care and go to great lengths to understand them not only from the medical perspective, but also in terms of everything going on in their lives — we provide whole person care.” “We are pleased to have achieved this prestigious recognition that signifies our dedication to achieving the highest standards for medical care for our patients,” said Al Maghazehe, chief executive of Capital Health. The PCMH is a model of primary care that combines teamwork and information technology to improve care, improve patients’ experience of care and reduce costs. Patient care is overseen by clinician-led care teams that coordinate treatment across the health care system. Achieving the PCMH recognition from NCQA “raises the bar in defining high-quality care by emphasizing access, health information technology and coordinated care focused on patients,” said NCQA President Margaret E. O’Kane. “Recognition shows that the Capital Health Center for Women’s Health has the tools, systems and resources to provide its patients with the right care, at the right time.” NCQA standards are aligned with the principles of the Patient-Centered Medical Home established with the American College of Physicians, the American Academy of Family Physicians, the American Academy of Pediatrics and the American Osteopathic Association.
April 2015 15
Cigna, Oncology Group Join Forces in Value-Based Care Program By Beth Fitzgerald The health insurer Cigna and Hackensack-based Regional Cancer Care Associates — one of the nation’s largest oncology practices, with thousands of patients throughout New Jersey — announced a new program to improve care for people receiving chemotherapy to treat any type of cancer. The program is an extension of Cigna Collaborative Care, a value-based initiative that uses incentives to encourage health care providers to seek improved health, affordability and patient experience. Initially focused on large primary-care physician groups, the collaborative has expanded to hospitals, small primary-care practices and specialists, including oncologists. The program encourages RCCA physicians to follow evidence-based medicine guidelines for cancer care and to use the expertise of COTA Inc., an oncology analytics company that tracks the quality of care and associated costs. In addition, RCCA will expand access to daily acute care with same-day appointment availability, after-hours access and after-hours clinical advice, including 24/7 access to clinical triage staff. “We’ve seen great results from our collaborative care arrangements with large physician groups,” said Dr. Ronald Menzin, senior medical director for Cigna in New Jersey. “Now we’re applying that successful model — which includes a care coordinator employed by the medical practice, and incentives that compensate physicians for the value of the care they deliver — to drive similar improvements in quality and cost of oncology care.” “The need to bring value to the health care system by avoiding under- and overutilization is essential to optimize patient outcomes and reduce overall cost of care,” said Dr. Andrew Pecora, president of RCCA. “Establishing this relationship with Cigna, and using new technologies like COTA that precisely measure variance in clinical and cost outcomes, will improve cancer care so that we can deliver better quality of life and a better experience for our patients each time they interact with our clinical team.” RCCA will designate a registered nurse or an advanced care practitioner as the group’s oncology care coordinator, who will assist patients and ensure their care is properly coordinated. Cigna will compensate the medical group with a one-time care management payment for each of its patients undergoing chemotherapy treatment. This incentive reimburses the group for its additional oversight and management of patient care. Cigna will also provide a single point of contact — a collaborative care associate — who will assist the medical practice’s oncology care coordinator with information about a Cigna customer’s benefits. Cigna will also provide oncology case management services for customers and their families who might need additional education or coordination of resources outside of the oncology practice. Cigna said it will soon launch a similar program with an oncology practice in Florida, and expects to have up to eight of these arrangements in place by the end of 2015. RCCA has more than 100 cancer care specialists supported by 700 employees at 25 locations throughout New Jersey, providing care to more than 23,000 new patients annually and over 240,000 existing patients. 16 Affiliated Practice
Chrysalis Medical Services Selects New Partner Collaborative Health Systems is leader in physician-led Medicare ACOs ATLANTIC CITY, N.J. –Chrysalis Medical Services, LLC has selectedCollaborative Health Systems (CHS), a subsidiary of Universal American Corp. (NYSE: UAM), as its partner to provide resources in care coordination, financial risk management, analytics and reporting, technology and other administrative services to its Medicare Accountable Care Organization (ACO),approved for participation in the Medicare Shared Savings Program starting January 2015. The partnership will enable Chrysalisphysicians to drive improvements in the quality and cost of care delivered to more than 11,000 Medicare Fee-For-Service beneficiaries in Atlantic, Cape May, and Ocean counties. Chrysalis selected CHS for its expertisein collaborating with provider groups around the country, helping them to take advantage of new alternative payment systems, such as ACOs, that reward physicians for healthcare quality and value. With the addition of Chrysalis, CHS has25 physician-led Medicare ACO partnerships, more than any other single company participating in the Medicare Shared Savings Program. In addition to analytical and technical resources, and Atlantic City-based staff, CHS will provide operating infrastructure, and expertise to supportChrysalis’ providers as they drive positive change in their healthcare market. Dr. Anthanasios Papastamelos, Chairman for Chrysalis Medical Services, saidhis physician group selected CHS because of its experience. “Collaborative Health Systems brings the expertise, infrastructure and perspective that we were looking for to move our physician community forward in the emerging value-based market,” he said. Jeff Spight, president of Collaborative Health Systems,said the partnership between CHS and Chrysalis will benefit both the healthcare providers and their patients. “We are excited about this partnership. Dr. Papastamelos has shown himself to be a great leader who is passionate about patient care and sees the benefit of putting Primary Care Physicians in the driver’s seat to coordinate patients’ care,” Spight said. “Our organizations are aligned on how we want to improve the quality of care patients receive, compensate physicians for delivering quality care, and reduce overall costs to the healthcare system.”
About Chrysalis Medical Services, LLC Chrysalis Medical Services, LLC was founded in 2013 by physician leaders to organize the physician community of Southern New Jersey and address the emerging population health initiatives.Chrysalisphysicians provide care to more than 11,000 patients in Atlantic City, N.J.
About Collaborative Health Systems Collaborative Health Systems (CHS) is a member of the Universal American Corp. (NYSE: UAM) family of healthcare companies. CHS partners with providers throughout the country in the development of Accountable Care Organizations (ACOs). CHS provides a range of care coordination, analytics and reporting, technology and other administrative services to enable physicians and other healthcare professionals to deliver improved care, improved health and lower healthcare costs to their patients. For more information, visit http://www.CollaborativeHealthSystems.com.
About Universal American Corp. Universal American (NYSE: UAM), through our family of healthcare companies, provides health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals in order to improve the health and well-being of those we serve and reduce healthcare costs. For more information on Universal American, please visit our website at www.UniversalAmerican.com. April 2015 17
Health Care Consulting Firm Laying Off 88 Workers By Beth Fitzgerald
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arlton-based Continuum Health Alliance, a consulting firm that helps physicians improve their clinical and financial performance, confirmed that it will lay off 88 workers June 5. The company’s planned workforce reduction was disclosed in a WARN notice the company was required to file with the state Department of Labor and Workforce Development. In a joint statement, Dr. John M. Tedeschi, chief executive officer, and Dr. Christopher T. Olivia, president, told NJBIZ: “Continuum is constantly evolving to better serve providers, patients and our communities. The changes we recently announced do not alter our mission of enabling physicians to improve quality of care, enhance the patient experience and lower the overall cost of care. By using proven partners who specialize in this area, Continuum is able to stay ahead of
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today’s rapidly changing health care landscape and quickly expand service capacity for current and new clients, without straining the company’s resources. “This was a difficult decision, given the contributions of those affected, but we remain deeply committed to our mission.” The Continuum disclosure was made pursuant to the New Jersey Worker Adjustment and Retraining Notification Act, or WARN. Under that law, midsized and large employers are required to provide the state with 60 days’ advance notice of layoffs. Founded in 1998 by pediatrician Tedeschi, Continuum provides practice management systems to medical practices, including billing, IT and human resources
Princeton’s Premier Senior Health Campus The Pavilions at Forrestal campus features two comprehensive centers that combine to deliver unparalleled senior care services. Our campus is home to post acute care and assisted living centers. Both offer a variety of on-site amenities and services specially designed to meet the needs of patients, residents and their family members. The Pavilions at Forrestal provides post acute, long term, Alzheimer’s / dementia and hospice care as well as rehabilitation and respite care, all under one roof. We offer state-of-the-art programs for physical, occupational, speech, respiratory and other therapies and our staff of licensed therapists is available seven days a week. Innovative supervised recreational activities in art, music, crafts and our exercise programs encourage social interaction and significantly enhance patients’ rehabilitation and quality of life. The Pavilions at Forrestal Assisted Living offers the independence of a private apartment and all the comforts of home with a host of convenient amenities and hospitality services. Residents enjoy delicious meals in a restaurant-style dining room, energizing fitness and wellness programs and a diverse range of cultural and social activities. The center also offers concierge service, weekly housekeeping services, courtesy van transportation, and much more. We take great pride in the care we deliver at both centers and our compassionate, experienced staff is focused on creating a warm environment that supports healing.
Pavilions at Forrestal Care Center
Pavilions at Forrestal Assisted Living
5000 Windrow Drive, Princeton, NJ Ph: 609-987-1221 | Fax: 609-987-8310
1000 Windrow Drive, Princeton, NJ Ph: 609-514-9111 | Fax: 609-419-1326
www.atriumhealthusa.com April 2015 19
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