About Advocate Health Network, LLC
Advocate Health Network, LLC is a physician-led organization that formed in July 2015 with St. Joseph’s/Candler Health System as sole member. Advocate Health Network (AHN) is an Accountable Care Organization (ACO) that was accepted to participate in the Shared Savings Program (SSP), effective January 2017, by the Centers for Medicare & Medicaid Services (CMS).
St. Joseph’s/Candler bears the sole responsibilities for all capital requirements of Advocate Health Network. The composition of the board is a physician majority structured board with two representatives from St. Joseph’s/Candler. The board of managers is a mix of primary care physicians and specialists, both independent and employed.
Only people with Original Medicare can be assigned to an Accountable Care Organization (ACO) such as Advocate Health Network.
AHN’s mission, values and vision statements
The St. Joseph’s/Candler Advocate Health Network is dedicated to addressing three objectives: improving outcomes, reducing costs and improvement of the experience for the beneficiary. The approach to this goal is guided by the St. Joseph’s/Candler mission, vision and value statements:
"Rooted in God’s love, we treat illness and promote wellness for all people.”
“To set the standards of excellence in the delivery of healthcare throughout the regions we serve.”
We believe the success of St. Joseph’s/Candler Health System will be directly related to the values we hold, share and practice. These values must form the basis for every action we take toward families, physicians, volunteers and each other:
Commitment to COMPASSION
Commitment to QUALITY
Commitment to INTEGRITY
Commitment to COURTESY
Commitment to ACCOUNTABILITY
Commitment to TEAMWORK
The Advocate Health Network believes in the six aims defined by the Institute of Medicine’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Specifically, healthcare at St. Joseph’s/Candler Health System and the ACO will be:
Safe – avoiding injuries to patients from the care that is intended to help them;
Effective – providing services based on evidence-based scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit both avoiding underuse and overuse;
Patient-centered – providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions;
Timely – reducing waits and sometimes harmful delays for both those who receive care and those who give care;
Efficient – avoiding waste, in particular waste of equipment, supplies, ideas and energy; and
Equitable – providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location and socioeconomic status.
How clinical integration improves health care?
Advocate Health Network (AHN) is a physician-led clinical integration network with collaboration a top priority. The more than 550 physician participants have a strong history of working collaboratively. This clinical experience makes health care safer and more efficient and lowers the cost of healthcare by improving the delivery of care. AHN does this two ways:
- Targeting areas for improvement using the data tracked with performance tools
Aggregated data will be used for multiple purposes allowing determination of healthcare costs per beneficiary and to analyze utilization patterns. The data will help the ACO in cost reduction, improved quality, expanded access and identification of areas of improvement. The addition of the Centers for Medicare & Medicaid Services’ (CMS) data on Medicare beneficiaries will improve the ACO’s ability to conduct additional, more population-specific activities and monitor in-network use by beneficiaries.
- Measuring physician performance against national benchmarks
The AHN has strategic performance targets for clinical quality and patient satisfaction metrics using CMS Medicare Shared Savings Program (MSSP) metrics and other applicable national benchmarks. The organizational stretch goal is to surpass the 90th percentile for these measures; each individual provider is expected to perform at least the national 50th percentile, or he or she will receive additional support and training.
What are Accountable Care Organizations?
Accountable Care Organizations (ACOs) are groups of doctors, hospitals and other health care providers who come together voluntarily to give coordinated high-quality care to their Medicare patients, according to the Centers for Medicare & Medicaid Services (CMS). The goal of coordinated care is to ensure that traditional Medicare patients, especially the chronically ill, get the right care at the right time while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
What is Medicare Shared Savings Program?
Advocate Health Network began operating a Medicare Shared Savings Program (MSSP) ACO in January 2017. MSSP rewards ACOs that lower their growth in health care costs while meeting performance standards on quality of care. Under MSSP, CMS will assess Advocate Health Network’s quality and financial performance based on a population of assigned beneficiaries to determine whether the Network met the quality performance standards and reduced growth in expenditures compared to a historical financial benchmark.
ACOs that meet or exceed a minimum savings rate and satisfy minimum quality performance standards are eligible to receive a portion of the savings they generated, according to the CMS. This is an incentive to an ACO to improve the coordination and quality of care for all patients seen by participating providers.
Learn more on the CMS website.