Medicare

Medicare

Medicare

Medicare patients are those on federal health insurance, typically people aged 65 or older and certain younger people with specific conditions or disabilities. Many people on Medicare live with health problems, including multiple chronic conditions, cognitive impairments, and limitations in their activities of daily living, and many beneficiaries live on modest incomes.

Patients in this population are covered under our Accountable Care Organization (ACO) model. Partners was chosen to participate in the Pioneer ACO from 2012-2016. Under the Pioneer ACO model, Partners achieved a total savings of more than $36.7 million and maintained an overall quality score of 94.5 percent. Following the conclusion of the pilot, Partners participated in the Next Generation (NextGen) ACO model from 2017-March 30, 2019. As Partners HealthCare evolves its work as an ACO, it was announced that Partners plans to transition from the NextGen ACO model to the Medicare Shared Savings Program Model (MSSP) with an anticipated start date of summer 2019.

While Partners Population Health programs today are offered to approximately 91, 000 Medicare patients across the Partners system, initial Medicare pilots programs started over 12 years ago at Massachusetts General Hospital (MGH). The MGH Care Management Demonstration would evolve into Partners Population Health suite of High-Risk Care Management programs. Since then, the suite has expanded to include innovative programs designed for the Medicare population in areas of home health, post-acute care, and remote monitoring technologies that can be used right in a patient’s home. We also support palliative care programs to better help patients with serious illnesses as they begin the difficult journey at the end of life. These programs are designed to meet the unique needs of our Medicare population; however, all our programs are available to Medicare patients if deemed appropriate by their care provider.

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