Walgreens' networks among new ACOs approved

The Centers for Medicare and Medicaid Services (CMS) recently approved 106 new accountable care organizations (ACOs) in Medicare, including three of Walgreens’ health networks.

CMS officials said the new ACOs represent a diverse cross-section of practices across the country. “We are very pleased by the growth in providers coming into the program … and the growth in diversity. More than 49 states plus Puerto Rico have one or more ACOs that are operating, and the organizations that are participating are both large and small,” said Jonathan Blum, deputy administrator and director at CMS, on a media call.

Now, more than 250 ACOs - which serve more than 10% of the fee-for-service Medicare beneficiaries - are represented, Blum added. The ACOs serve more than 4 million Medicare beneficiaries nationwide.

Expanding role of pharmacists

The approved Walgreens ACOs include Advocare Walgreens Well Network, Diagnostic Clinic Walgreens Well Network, and Scott & White Walgreens Well Network. “For Walgreens, the innovative, pharmacy-run ACO model is another example of how we are continuing to transform and expand the role of our community pharmacists into a more truly consultative role,” said Ron Weinert, Walgreens’ vice president of Health Care Solutions. “The ACO structure provides more opportunities to play an even larger role in helping to drive better patient outcomes and cost savings, offering more health care services while working as an integrated part of patients’ care teams.”

Roughly half of all ACOs are physician-led organizations that serve fewer than 10,000 beneficiaries. Approximately 20% of ACOs include community health centers, rural health centers, and critical access hospitals that serve low-income and rural communities.

While CMS received 170 ACO applications for 2013, it approved only 106 because some of the organizations that applied did not have the required threshold of 5,000 beneficiaries.

“To demonstrate true cost savings by the statute, they have to demonstrate that they can serve 5,000 or more beneficiaries,” said Tricia Rodgers, deputy director of CMS’s Performance-Based Payment Policy Group, on the media call. However, CMS let the ACOs that were not approved know the changes they could make, so they could be eligible for next year.

- Christine Blank, Contributing Editor