Using Gainsharing to Transition to an ACO at JFK Health: 6 Critical Success Factors
Implementing an ACO is one of the most difficult strategic transformations that a health care system can attempt. The alignment of physicians and hospitals that comes from gainsharing helps to ensure a successful ACO launch.
Using Gainsharing to Transition to an ACO at JFK Health: 6 Critical Success Factors examines one organization’s experience with how a gainsharing program helped in its transition to an ACO. The article was featured in the December 2014 issue of Accountable Care News, and is coauthored by myself and William Oser, MD, the Acting Executive Director, JFK Health ACO; Senior Vice President and Chief Medical Officer, JFK Health (Edison, NJ).
JFK Health implemented its gainsharing program in 2009 as part of the New Jersey Hospital Association (NJHA) Medicare Demonstration, and later as part of its BPCI Model 1 Gainsharing Program. In 2013, the shared responsibility and trust developed through gainsharing led to the formation of the JFK ACO which coordinates the care of more than 11,000 Medicare beneficiaries. The JFK ACO expanded to care for more than 8,000 Horizon BCBSNJ members in 2014.
Dr. Oser and I explore how the 6 critical success factors to successfully using gainsharing facilitated JFK Health’s formation of an ACO. These factors are:
- Ensure Patient Protection
- Establish Quality Components
- Establish Institutional Safeguards
- Condition Payments To Ensure Program Integrity
- Work with a Third Party Facilitator
- Build on a Sound Foundation
Gainsharing began the process of aligning the goals of JFK’s physicians with those of the health system. It provided the framework for collaboration and contributed to an organizational focus on improving quality and lowering costs that is essential for the JFK ACO to succeed in larger population health initiatives.
