Actualización de la política de no discriminación

Boston Medical Center Health System cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de edad, raza, color, origen nacional (incluido el dominio limitado del inglés y el idioma principal), religión, cultura, discapacidades físicas o mentales, estatus socioeconómico, sexo, orientación sexual e identidad y/o expresión de género. BMCHS proporciona ayuda y servicios gratuitos a personas con discapacidades y servicios lingüísticos gratuitos a personas cuyo idioma principal no es el inglés.

Para leer nuestra Declaración de no discriminación completa, haga clic aquí.

Accountable care organizations (ACOs) are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to give coordinated, high-quality care to their patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time while preventing medical errors and avoiding the unnecessary duplication of services. By helping doctors and primary care providers to communicate more closely with other healthcare providers, ACOs can also deliver care that better meets patients’ individual needs and preferences.

Boston Accountable Care Organization, Inc. (BACO) and BMC Integrated Care Services, Inc. (BMCICS) are both accountable care organizations.

Boston Accountable Care Organization (BACO)

Mission and Vision

As an accountable care organization, the mission of the Boston Accountable Care Organization, Inc. (BACO) is to improve the healthcare of the populations served by our network, better managing all aspects of healthcare and improving the overall health of the population served while operating more efficiently. BACO integrates the resources of its participants and their affiliated physicians to provide more effective, higher quality, and less expensive care for patients.

Faithful to the spirit of partnership and innovation, while fulfilling BMC’s mission of providing exceptional care to all, BACO is a leader in the provision of patient care that:

  • Improves its patients’ experience of care
  • Improves the health of all patients served
  • Addresses the specific healthcare needs of vulnerable populations
  • Reduces the costs of the healthcare it provides

We accomplish these aims through an integrated delivery system that coordinates care across the continuum — providing the right care at the right place at the right time.

Programs

BACO is an innovator and leader around issues core to Medicaid patients. For example:

  • Our complex care management program improves outcomes for patients with complex, chronic disease and multiple health-related social needs. This video illustrates the impact of our program on one patient, Carl:
  • We are publishing cutting-edge research and perspectives on relevant topics, such as access to long-acting contraceptives.
  • We are piloting innovative solutions to help our patients experiencing homelessness and housing insecurity, including developing our housing services department, Living Well at Home, and creating supportive housing partnerships with local housing agencies and property owners.

Leadership

Board of Directors

President Elect: Cynthia H. Sierra, CEO of Manet Community Health
Treasurer: William Creevy, MD
Clerk: David Beck
Executive Director: Michael Olsen
Medical Director: Jason Worcester

Patient Advisory Committee

The needs and desires of the patient population of the Boston Accountable Care Organization is at the forefront of our work. To that end, as a part of its governance structure BACO has a Patient Advisory Committee that currently reports to its Board of Directors. The purposes of the Committee are to assist the Board in meeting its responsibilities to ensure that the interests of the ACO’s patients and their families are met.

The Committee has appointed a consumer representative to sit on BACO’s Board of Directors and, in the near future, intends to recommend a consumer or consumer advocate to represent patients with disabilities to the Board or one of its Committees.

Member Rights & Grievance Policy

Member Rights

The Boston Accountable Care Organization represents medical practices, health centers, and systems across the state that are committed to improving the care you receive.

As a member who receives services through an accountable care organization, you are guaranteed the following rights:

  1. The right to receive written information provided by Boston Accountable Care Organization in accordance with the following requirements:
    1. Making such information available in prevalent non-English languages.
    2. Making free oral interpretation services available for all non-English languages.
    3. Making such information available in alternative formats and in an appropriate manner that takes into consideration the special needs you may have.
  2. The right to be treated with respect and with due consideration for your dignity and privacy;
  3. The right to receive information on available treatment options and alternatives, presented in a manner appropriate to your condition and ability to understand;
  4. The right to participate in decisions regarding your healthcare, including the right to refuse treatment;
  5. The right to be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience, or retaliation, in accordance with applicable federal law;
  6. The right to request and receive any of your medical records in your provider’s possession, and be notified of the process for requesting amendments or corrections to such records;
  7. The right to freely exercise your rights set forth in this section and not have the exercise of those rights adversely affect the manner in which Boston Accountable Care Organization or any Affiliated Provider treats you.

These rights will be observed and protected by Boston Accountable Care Organization, its Affiliated Providers, and its employees.

Grievance Policy

BACO has established a policy to file a grievance if you are dissatisfied with the care you received. Upon receipt of a grievance, you will be notified within two business days that BACO received the grievance. The grievance will be reviewed and resolved within 30 calendar days from the date that BACO received the grievance and you will be notified of the resolution.

Boston Accountable Care Organization’s grievance policy in no way replaces or eliminates access to any other available grievance policies and procedures, including those of the Massachusetts Executive Office of Health and Human Services. In addition, Boston Accountable Care Organization will not seek to limit your access to or discourage you from using the Massachusetts Executive Office of Health and Human Services process.

To file a grievance you should contact the Senior Administrative Assistant of Boston Accountable Care Organization by either calling 617.414.1673 or mailing a written grievance to the following address:

Boston Accountable Care Organization, Inc.
Attention: Senior Administrative Assistant
720 Harrison Avenue
10th Floor, Room 1029A
Boston, MA 02118

BMC Integrated Care Services (BMCICS) and the Medicare Shared Savings Program

About BMC Integrated Care Services

BMC Integrated Care Services (BMCICS) promotes the highest quality of coordinated patient care, patient safety, and cost-effective care among its participating providers through our integrated and coordinated managed care contracts and related medical management programs.

BMCICS has been designated as a Medicare Shared Savings Program Accountable Care Organization (ACO).

BMCICS provides information to physicians and their staff on our managed care contracts, their requirements, and their implementation processes.

Our medical management program supports our providers in promoting high-quality, efficient care by:

  • Minimizing variations in practice via monitoring of quality and effectiveness
  • Requiring monthly quality reports
  • Providing prior authorizations for medically necessary or medically appropriate care
  • Conducting provider and member surveys
  • Credentialing and re-credentialing providers

Contact Information

Phone: 617.478.3525
Fax: 617.897.0860
Email: MSOGroupBox@BMCHP-wellsense.org

Public Reporting

ACO Name and Location

BMC Integrated Care Services, Inc.
One Boston Medical Center Place
Boston, Massachusetts 02118

ACO Primary Contact

Primary Contact Name

Priscilla O’Heir

Primary Contact Phone Number

617.414.1673

Primary Contact Email Address

priscilla.oheir@bmc.org

ACO Participants

ACO Participant Name

ACO Participant in Joint Venture (Enter Y or N)

Trustees of Boston University

Y

Child Health Foundation of Boston, Inc.

Y

Mattapan Community Health Center, Inc.

Y

Manet Community Health Center, Inc.

Y

Codman Square Health Center, Inc.

Y

South Boston Community Health Center, Inc.

Y

Boston University Mallory Pathology Associates, Inc.

Y

Internal Medical Associates-NeighborHealth

Y

Boston University Obstetrics and Gynecology Foundation, Inc.

Y

BUMC Otolaryngologic Foundation, Inc.

Y

Boston University Affiliated Physicians, Inc.

Y

Boston University General Surgical Associates, Inc.

Y

Boston University Medical Center Radiologists, Inc.

Y

Boston Emergency Physician Foundation, Inc.

Y

Boston University Medical Center Urologists, Inc.

Y

Boston University Neurosurgical Associates, Inc.

Y

Boston Medical Center Corporation

Y

Boston University Dermatology, Inc.

Y

Boston University Family Medicine, Inc.

Y

Boston University Orthopaedic Surgical Associates, Inc.

Y

Boston University Psychiatry Associates, Inc.

Y

Boston University Neurology Associates, Inc.

Y

DOT HOUSE HEALTH, INC.

Y

Upham’s Corner Health Committee, Inc.

Y

Evans Medical Foundation, Inc.

Y

Boston University Radiation Oncology, Inc.

Y

Boston University Medical Center Anesthesiologists, Inc.

Y

Boston University Eye Associates, Inc.

Y

Harbor Health Services, Inc.

Y

Harvard Street Neighborhood Health Center, Inc.

Y

ACO Governing Body

Member

Member’s Voting Power

Membership Type

ACO Participant TIN Legal Business Name/DBA, if Applicable

Last Name

First Name

Title/Position

Bell

Alastair

Director

16.66%

ACO Participant Representative

Boston Medical Center Corporation

Davidoff

Ravin

President

16.66%

ACO Participant Representative

Boston Medical Center Corporation

Creevy

William

Director

16.66%

Other: President of Boston University Medical Group

Boston University Orthopaedic Surgical Associates, Inc.

Henderson

David

Director

16.66%

ACO Participant Representative

Boston University Psychiatry Associates, Inc.

Halpin

William

Director

16.66%

ACO Participant Representative

South Boston Community Health Center, Inc.

Gazey

Kenneth

Director

16.67%

ACO Participant Representative

Consumer Representative

Key ACO Clinical and Administrative Leadership

Name

Position

(Email Address)

Michael Olsen

ACO Executive

michael.olsen@bmc.org

Jason Worcester

Medical Director

jason.worcester@bmc.org

Craig Bennett

Compliance Officer

Jason Worcester

Quality Assurance/Improvement Officer

Associated Committees and Committee Leadership

Committee Name

Committee Leader Name and Position

Finance/Budget Committee of Boston Accountable Care Organization, Inc.

William Creevy, MD — President of Boston University Medical Group

Quality Committee

Jason Worcester, MD — Medical Director, Boston Accountable Care Organization, Inc.

Types of ACO Participants, or Combinations of Participants, That Formed the ACO

  • Partnerships or joint venture arrangements between hospitals and ACO professionals

Shared Savings and Losses

Amount of Shared Savings/Losses

  • Third Agreement Period
    • Performance Year 2023, $6,691,841
    • Performance Year 2022, $6,544,936
    • Performance Year 2021, $4,671,498
  • Second Agreement Period
    • Performance Year 2020, $7,087,868
    • Performance Year 2019, $2,352,403
    • Performance Year 2018, $1,905,632
  • First Agreement Period
    • Performance Year 2017, $0
    • Performance Year 2016, $0
    • Performance Year 2015, $4,217,885

Shared Savings Distribution

  • Third Agreement Period
    • Performance Year 2023
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2022
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2021
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
  • Second Agreement Period
    • Performance Year 2020
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2019
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
    • Performance Year 2018
      • Proportion invested in infrastructure: 20%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 80%
  • First Agreement Period
    • Performance Year 2017
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2016
      • Proportion invested in infrastructure: N/A
      • Proportion invested in redesigned care processes/resources: N/A
      • Proportion of distribution to ACO participants: N/A
    • Performance Year 2015
      • Proportion invested in infrastructure: 0%
      • Proportion invested in redesigned care processes/resources: 0%
      • Proportion of distribution to ACO participants: 100%

Quality Performance Results

2023 Quality Performance Results

Quality performance results are based on the Centers for Medicare and Medicaid Services (CMS) Web Interface.

Measure #

Measure Name

Rate

ACO Mean

001

Diabetes: Hemoglobin A1c (HbA1c) Poor Control[1]

10.20

9.84

134

Preventative Care and Screening: Screening for Depression and Follow-up Plan

76.73

80.97

236

Controlling High Blood Pressure

65.08

77.80

318

Falls: Screening for Future Fall Risk

84.55

89.42

110

Preventive Care and Screening: Influenza Immunization

73.77

70.76

226

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

75.44

79.29

113

Colorectal Cancer Screening

70.63

77.14

112

Breast Cancer Screening

83.06

80.36

438

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

92.44

87.05

370

Depression Admission at 12 Months

14.29

16.58

321

CAHPS for MIPS[3]

7.49

6.25

479

Hospital-Wide, 30-Day, All-Cause Unplanned Readmission (HWR) Rate for MIPS Groups[1]

0.1472

0.1553

484

Clinician and Clinician Group Risk — Standardized Rates for Patients with Multiple Chronic Conditions[1]

N/A

35.39

Please note: [1] A lower performance rate corresponds to higher quality. [2] For PY 2022, the CMS Web interface measures Quality ID #438 and Quality ID #370 do not have benchmarks, and therefore were not scored. [3] CAHPS for MIPS is a composite measurement, so numerator, denominator, and performance rate values are not applicable (N/A). The CAHPS for MIPS composite score is circulated as the average number of points across Scored Summary Measures (SSMs) (86 FR 65256). Refer to the table below for details on CAHPS for MIPS Performance.

CAHPS for MIPS Performance

Measure ID

Measure Name

Reported Performance Rate

Current Year Mean Performance Rate (SSP ACOs)

CAHPS-1

Getting Timely Care, Appointments, and Information

82.50

83.68

CAHPS-2

How Well Providers Communicate

94.39

93.69

CAHPS-3

Patient’s Rating of Provider

94.81

92.14

CAHPS-4

Access to Specialists

79.84

75.97

CAHPS-5

Health Promotion and Education

74.91

63.93

CAHPS-6

Shared Decision Making

59.36

61.60

CAHPS-7

Health Status and Functional Status

69.00

74.12

CAHPS-8

Care Coordination

87.39

85.77

CAHPS-9

Courteous and Helpful Office Staff

92.38

92.31

CAHPS-11

Stewardship of Patient Resources

31.57

26.69

For previous years’ Financial and Quality Performance Results, please visit CMS Data (Data.CMS.gov)

Payment Rule Waivers

  • Skilled Nursing Facility (SNF) 3-day Rule Waiver:
    • Our ACO uses the SNF 3-Day Rule Waiver, pursuant to 42 CFR §425.612.
  • Waiver for Payment for Telehealth Services:
    • Our ACO clinicians provide telehealth services using the flexibilities under 42 CFR §425.612(f) and 42 CFR §425.613.

Patient Advisory Committee

The needs and desires of the patient population of BMC Integrated Care Services (BMCICS) is at the forefront of our work. To that end, the BMC Integrated Care Services, as a part of its governance structure, has a Patient Advisory Committee. The purpose of the Committee is to assist the Board in meeting its responsibilities to ensure that the interest of the ACO’s patients and their families are met. The Committee has appointed a consumer representative to sit on the BMC Integrated Care Services’ Board of Directors, and intends to recommend a consumer or consumer advocate to represent patients with disabilities to the Board or one of its Committees, in the near future.