NCMS Foundation’s Rural ACO Initiative Pioneering New Territory

The ambitious initiative that recently received a nearly $500,000 grant from the Kate B. Reynolds Charitable Trust is pioneering new territory in rural North Carolina. The project seeks to help rural practices make the transition to an Accountable Care Organization (ACO) model. ACOs are built on the ‘triple aim’ of improving the health of a patient population, improving patient experience and lowering cost.

North Carolina is fertile ground for the formation of ACOs and many are already well-established like Cornerstone Health Care in High Point, Coastal Carolina Health Care in New Bern and Wilmington Health in Wilmington. All ACOs face challenges in successfully coordinating patient care among a variety of doctors and support services, collecting data through electronic health records and analyzing that information to make improvements in patient care and realize cost efficiencies. Practices in rural communities, have particular challenges when it comes to resources and expertise.

The North Carolina Medical Society Foundation’s (NCMSF) Rural ACO Initiative, with the help of the recent grant from the Trust, seeks to help practices in rural areas meet those challenges. NCMSF has partnered with CHESS, a management services organization based in High Point, which will provide education and training to prepare practices for participation in the MSSP and other value-based models.  The NCMSF will offer practice management consulting services and leadership development training. Also, the NCMSF’s Community Practitioner Program is an integral part of this initiative. Learn more about the NCMSF consulting services, leadership development programs and its Community Practitioner Program.

In recent meetings with the initial practices participating in the project, NCMSF Director of Rural Health Initiatives Franklin Walker said the first hurdle will be in meeting the 5,000 patients that need to be attributed to the ACO in order to qualify for the Medicare Shared Savings Program (MSSP) funding.

“Getting to the minimum number of assigned lives is a huge task,” he said, noting the attrition rate for an urban practice is usually around 20-25 percent, but in a rural area the rate sky-rockets to 50-75 percent. Attrition refers to the number of Medicare fee for service beneficiaries that did not receive a plurality of primary care services from the ACO practices and therefore were not counted as assigned beneficiaries for that ACO.

Meetings are ongoing to determine how best to position rural practices to succeed.




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