Initiative positions ACO to develop the right model for Medicare Shared Savings Program success
In 2016, six Michigan health systems formed Affirmant Health Partners, a clinically integrated network (CIN), to achieve a vision of a healthy Michigan at an affordable cost.
Affirmant wanted to leverage the clinical expertise of its member health systems — Bronson Healthcare, Covenant HealthCare, Henry Ford Health System, Lakeland Health, MidMichigan Health, and Sparrow Health System — and its 6,000 physicians.
To do so, Affirmant would have to establish a sufficient and sustainable source of funding by engaging in mutually beneficial partnerships with private and public payers. Affirmant needed an effective strategy, a structure that would empower individual and organizational success, and a road map for achieving strong value for a large population.
In 2016, Affirmant partnered with Guidehouse to establish the organizational philosophy for the initiative, develop the right operating model, and define the focus for its first year’s clinical, contracting, and IT programs.
Affirmant’s leaders knew they wanted to establish health plan partnerships — specifically with Medicare Advantage and commercial health plans — to create a “runway to value.” Guidehouse’s extensive experience with accountable care organizations (ACOs) pointed to the value of supplementing this approach through participation in the Medicare Shared Savings Program (MSSP) — especially during the first year of formation of its own ACO, The Federation ACO.
“Initially, our objectives for participating in the MSSP did not include an expectation of earning shared savings,” says Bill Mayer, MD, MPH, and president and CEO of Affirmant Health Partners. “Navigant helped us understand there are clear reasons for participating in the MSSP as you pursue a CIN strategy. For one, it provided access to extensive data that substantially informed performance improvement. Second, the large number of traditional Medicare plan patients meant participation in the MSSP would enhance our relevance in the minds of our physicians. Finally, as we transform clinical practice, we anticipated changes would occur for all payers, and we didn’t want to leave any value on the table that might be created for traditional Medicare.”
The Federation ACO’s members include Bronson Healthcare, Covenant HealthCare, Henry Ford Allegiance Health, Lakeland Health, and Sparrow Health. Affirmant’s other members, MidMichigan Health and Henry Ford Health System, were already members of other ACOs when The Federation ACO was formed.
As we moved toward becoming an ACO, it was critically important to have the right people on our team. Guidehouse’s senior consultants brought exemplary expertise and real-world experience to their work with us. They were true strategic partners in creating the road map for our journey and achieving extraordinary results.”
Bill Mayer, MD, MPH, President and CEO
Affirmant Health Partners
Strategy & Innovation