Carilion Clinic, a multi-specialty group practice with 500 physicians and seven not-for-profit hospitals, initiated an ACO-like model four years ago. By focusing on patient-centered care and accountability for cost, quality, and outcomes, Carilion shifted its focus from “our hospital” to “our community.” In line with its mission to “provide access to the full spectrum of quality health care and related services, improve health status and promote healthy lifestyles in the community served,” Carilion established a physician leadership structure, instituted a comprehensive electronic medical record system, and developed a new medical school and research center.
Parent Organization Specifications
Type: Integrated Delivery System
Legal Structure: 501(c)3
Patients Served Annually: 1.4 million physician visits; 47.5k hospital admissions
Number Associated Hospitals: 7
Number of Hospital Beds: 1,100
EHR Capabilities: Full Enterprise-Wide
Other Reform Efforts: Primary Care Medical Home, Anceta Project
Clinical Transformation Tools: EHR, P4P, outcome reporting, aligned incentives
ACO Specifications
Governance Structure: Clinical Senior Management Team
Legal Structure: 501(c)3 of Parent Organization
Participating Payers in Year 1: TBD for Year 1
Date Initiated Discussions with Payers: May 2010
Year 1 Shared Savings Model: Shared Savings
Quality Metrics Used in Year 1: Brookings-Dartmouth Starter Set
ACO Primary Care Providers: 150
ACO Medical Specialists: 250
ACO Surgical Specialists: 100