title: Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.
abstract: Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.
authors.affiliation: S.A. Berkowitz is senior medical director of accountable care, Office of Johns Hopkins Physicians, and assistant professor of medicine, Division of Cardiology, both at Johns Hopkins University School of Medicine, Baltimore, Maryland. He is also executive director, Johns Hopkins Medicine Alliance for Patients, LLC, Glen Burnie, Maryland. L. Ishii is associate professor and director of research of facial plastic and reconstructive surgery, Department of Otolaryngology-Head & Neck Surgery, senior medical director of clinical integration, Office of Johns Hopkins Physicians, and medical director, Johns Hopkins White Marsh Surgery Center, all at the Johns Hopkins University School of Medicine, Baltimore, Maryland. J. Schulz is a third-year medical student, Johns Hopkins University School of Medicine, Baltimore, Maryland. M. Poffenroth is chief medical officer, Signature Partners Network, Inova Health System, Fairfax, Virginia. He is also former medical director, Johns Hopkins Medicine Alliance for Patients, LLC, Glen Burnie, Maryland.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Berkowitz
authors.forename: Lisa
authors.initials: L
authors.lastname: Ishii
authors.forename: John
authors.initials: J
authors.lastname: Schulz
authors.forename: Matt
authors.initials: M
authors.lastname: Poffenroth
mesh_terms: D000046:Academic Medical Centers; D060866:Accountable Care Organizations / Q000458:organization & administration*; D015142:Baltimore; D003153:Community Health Services; D003159:Community-Institutional Relations; D003299:Cooperative Behavior; D006801:Humans