Frequently Asked Questions
What is an ACO?
An ACO (Accountable Care Organization) is a group of member physicians and hospitals who agree to follow the defined structure of care as outlined, in the HFACO’s case, by Medicare. This structure, built to achieve true clinical integration of care, focuses on communication between member physicians and hospitals to improve the continuity of care for patients, reduce duplicative testing, increase the focus of care for chronic conditions and reduce costs for all involved – patients, physicians and hospitals.
Why is Henry Ford Health System accepting this ACO invitation?
The Next Generation ACO model creates a win-win situation for both beneficiary (patient) and provider (physician and hospital) based on its financial structure, improved and increased benefits and innovative allowances for a higher level of care.
Why were previous ACOs not suited to Henry Ford Health System?
Henry Ford Health System previously investigated the Medical Shared Savings Program (MSSP) and Pioneer ACO models but found them lacking in both substance and benefit for all involved. As an organization focused on providing innovative and comprehensive care, HFHS opted out of previous ACOs so that our physicians and hospitals could continue to provide the care we thought was necessary, without the restrictions of an ACO that was not in alignment with our overall objectives.
What patients does the HFACO impact?
The HFACO serves only traditional Medicare patients assigned to it by Medicare.
Why are only Medicare patients included in the HFACO?
While there are ACOs that apply to younger patients, the Next Generation model is designed specifically for those patients receiving traditional Medicare.
Can beneficiaries (patients) keep their same provider (doctor and hospital)?
If a physician is currently part of the Henry Ford Health System, or if a specialist is a member of the HFACO, then the beneficiary can keep their current provider. All members of the Henry Ford Medical Group and all Henry Ford Health System employed physicians are automatically part of the HFACO. Private practice specialists will be invited into the HFACO, based on their achievements in the field.
How does the HFACO benefit patients?
Patients, or beneficiaries, will benefit through the application of proven best practices that reduce costs and improve the care they receive. Patients will see improved communication between the doctors they see, less duplication of tests, more services such as telemedicine, more opportunity for home visits, and even a “loyalty” payment from Medicare for staying within the HFACO for care.
How does this affect out-of-pocket costs for patients?
Because of increased communication between physicians, test and procedure results will be shared easily and quickly, resulting in fewer double orders of the same test. Better care for chronic conditions also results in greater health and, hence, decreased hospital or urgent care visits and potentially, fewer medications. All of these factors will impact the amount paid out by patients. Additionally, patients who stay within the HFACO for 15% of their care during a calendar year will receive a check from Medicare, rewarding them for their loyalty.
How can a Medicare patient start receiving their care from the HFACO?
Medicare patients whose physician is part of the Henry Ford Health System or is a specialty physician who has been invited into the Henry Ford ACO are automatically part of the HFACO. A list of private practice specialists who are part of the HFACO can be found on the website at www.HenryFordACO.com.
How does the HFACO benefit doctors and hospitals?
HFACO member physicians and hospitals are compensated financially for achieving very specific care outcomes for patients. Conversely, the HFACO is penalized financially for not reaching the goals as outlined by Medicare.
How will this impact Henry Ford Health System financially?
Simply put, HFHS and the members of the HFACO benefit financially for reaching overall care objectives as outlined by Medicare. These objectives are fully supported by HFHS and the HFACO as best practices, many of which are already being applied to the care of our Medicare patients. The difference is that now the HFACO will be financially compensated by Medicare for achieving these objectives.
Who is in charge of the HFACO?
Charles Kelly, D.O., is the Executive of the HFACO. Dr. Kelly is also President and CEO of the Henry Ford Physician Network, which aligns nearly 1,800 physicians, hospitals and ancillary services around new initiatives for clinical integration and quality improvement efforts. Bruce Muma, M.D. is Chief Medical Officer of the HFACO, and acts in the same capacity for the Henry Ford Physician Network.
How long is this ACO contract?
The contract term is for three years. After that time, both sides can reevaluate to see if the relationship will continue.