Additional $31 million also provided by Center for Medicare and Medicaid Innovation (CMMI) to prepare rural practices for value-based payments under new Practice Transformation Network
A pioneering group of rural physicians and hospital administrators came together in 2013 to begin the journey toward managing rural population health. Through innovation and collaboration, they sought to transform today’s rural healthcare delivery system into a world-class primary care system that provides professional satisfaction for clinicians, attracts consumers, and provides high-quality acute, post-acute and outpatient services that meet patients’ needs.
These rural thought-leaders joined forces to form the first National Rural ACO (NRACO) and create the NRACO Services Corporation (NSC), which has been supporting rural Medicare ACOs with training, data, analytics, patient satisfaction surveys, and evidence-based medicine programs since 2014. In 2015, NSC organized more than 6,000 providers in 159 rural health systems into 23 Medicare Shared Savings Program (MSSP) ACOs, and obtained $46 million in ACO Investment Model funding to support their ACO operations and local care coordination programs. This group includes 55 rural PPS hospitals, 92 Critical Access Hospitals, 168 Rural Health Clinics, and 39 rural FQHCs serving more than 500,000 Medicare patients.
Working with other key stakeholders like the National Rural Health Association and the National Rural Health Resource Center, the rural hospital CEOs also started the non-profit National Rural Accountable Care Consortium. The Consortium will assist hundreds of rural health systems in their journey toward accountable care, funded by a $31 million cooperative agreement award from the CMMI.
To date, the majority of National Rural ACO participants have demonstrated reductions in per capita spending while improving quality and patient satisfaction. Unexpectedly, this has also resulted in financially strengthening the majority of the participating rural health systems. Participating hospital CFOs are queried monthly on the financial status of their organizations, and none have reported negative effects of being associated with accountable care, while most have described increased revenue and improved staff satisfaction.
According to NRACO founding member Tim Putnam, CEO of Margaret Mary Health in Batesville, Indiana, “there will be significant opportunities to strengthen rural health systems by becoming an ACO or participating in a CMMI innovation model in the next 1-2 years, but providers must prepare.” Co-founder Melanie Van Winkle, CFO of Mammoth Hospital in Mammoth Lakes, California agrees, saying “this is the reason we exist, to take care of the community. The ACO helps us focus on our mission.” Steve Barnett, CEO of McKenzie Health in Sandusky, Michigan adds, “once you begin giving this type of care, you’ll never go back. We are very grateful for the support we have received from CMS, CMMI, MedPAC, and the Federal Office of Rural Health Policy. We wouldn’t be able to organize rural providers under this model without their help.”
Today, rural providers can get all of the support they need to be ready for value-based payments through the Consortium’s Practice Transformation Network, fully funded by CMMI. Medical office staff will be trained in population health management, including care coordination, quality improvement, annual wellness visits, and patient satisfaction, and can begin billing for these professional services.
Spaces are still available to join the Consortium’s Practice Transformation Network. In order to enroll in this federally-funded program that provides a population health infrastructure to rural practices at no cost, go to this website.