Three accountable care organizations (ACOs) driven by Walgreens were among the 106 new ACOs announced by CMS on January 10.
The first pharmacy to create any ACO, Walgreens approached the affiliated physicians’ groups in New Jersey, Florida, and Texas. “Walgreens pharmacists will be integrated into patients’ care teams, serving as accessible providers working closely with physicians,” Walgreens spokesperson Jim Cohn told pharmacist.com.
Pharmacists will facilitate adherence programs through face-to-face medication counseling and other services. They can administer a wide range of immunizations, and also work with patients to improve overall health and wellness by offering health testing for diseases like diabetes and hypertension. “They also will be liaising more directly with affiliated physicians’ groups to ensure patients are getting the right care in the right setting and taking their medications correctly to help prevent unnecessary hospital readmissions or other complications,” Cohn said.
“The Walgreens ACOs created new partnerships with pharmacists and primary care providers, and we are pleased that pharmacists are taking an active part in this effort to improve the nation’s health care system,” Jonathan Blum, CMS Acting Principal Deputy Administrator and Director, Center for Medicare, told pharmacist.com.
“Our goals to improve the health of individuals, to improve the care for populations, and to lower the growth in health care spending require a team that will work together at every stage of patient care, and pharmacists can be key members of that team,” Blum added. “We look forward to the partnership to help set Medicare on a more sustainable path today and into the future.”
The 106 new ACOs may cover 4 million Medicare patients, according to the CMS news release. Since the Affordable Care Act (ACA) was passed, more than 250 ACOs have been established.
The final rule for ACOs was published November 2, 2011, and became effective January 3, 2012. It implemented section 3022 of ACA, which established the Medicare Shared Savings Program that is intended to encourage the creation of ACOs. Under the program, ACOs continue to receive Medicare fee-for-service payments under Parts A and B, but are also eligible for additional Medicare payments. ACOs meeting specified quality and savings requirements share a percentage of the savings they’ve generated.
Advocare Walgreens Well Network is in Marlton, NJ; Diagnostic Clinic Walgreens Well Network is in Largo, FL; and Scott & White Healthcare Walgreens Well Network, LLC, is in Temple, TX. “We see this as a natural evolution of our business,” Cohn said. “We believe we have a unique model with an expansive footprint of retail locations and Take Care Clinics, through which we can play an integral role in driving shared savings and improved patient care through collaboration—which are the key goals of the ACO model.”
While the ACO final rule does not list pharmacists as eligible professionals to form ACOs or be eligible for shared savings, pharmacists can participate in ACOs. Asked if Walgreens pharmacists will somehow be able to participate financially in the new ACOs, Cohn said, “Walgreens as a whole will be participating in the savings, but we cannot provide more information about potential future financial elements of the ACOs at this time.”