Baptist Health System in San Antonio has been selected as one of only five health systems to participate in the Medicare “Acute Care Episode” (ACE) Demonstration project aimed at reshaping the way health care is delivered in the United States. Baptist was the only health system in Texas selected by the Centers for Medicare and Medicaid Services (CMS) to host the demonstration.
The Baptist Health System was selected based on a variety of factors including the high quality standards in selected cardiac and orthopedic services, and its commitment to work with physicians and suppliers to keep costs low. “Like CMS, Baptist Health System is committed to improving the quality of patient care, and creating efficiencies and savings in the delivery of care, so we are happy to do our part in helping CMS investigate potential improvements in the way health care services are delivered,” said Trip Pilgrim, President and CEO of Baptist Health System.
The three-year Demonstration program began at Baptist on June 1. New processes being tested in the ACE model at all five of the Baptist Health System hospitals will create improved coordination of care for Medicare beneficiaries, and will result in a “share of savings” payment for eligible Medicare beneficiaries.
The market-based mechanisms being used in the ACE project to achieve improved quality and efficiency are: bundled payment, competitive bidding, gain-sharing and shared savings. The demonstration will test the use of bundled payments and gain-sharing for hospital and physician services for 9 orthopedic and 28 cardiac services to determine whether improvements in quality of care result from aligning financial incentives between hospitals and physicians in such a way as to facilitate and improve the coordination of care for these patients.
This demonstration provides an opportunity for Medicare to share savings achieved through the demonstration with beneficiaries who, based on quality and cost, choose to receive care from participating demonstration providers. However, beneficiaries will still be able to choose a hospital that best meets their needs and will not be restricted by this demonstration. Medicare will share 50 percent of the savings it gains under the demonstration with the Medicare beneficiary up to a maximum of $1,157.
The ACE Demonstration was designed by CMS as a way to determine what works to raise quality and reduce costs of health care. CMS will evaluate the Demonstration and make the results available to help bring about future improvements in the Medicare program.