Steward physicians and Saint Anne’s Hospital join innovative MassHealth program to improve health care outcomes for members

By Saint Anne's Hospital | Nov 13, 2017

Fall River, MA – Through the new Steward Health Choice health plan designed and tailored to better serve MassHealth patients, Greater Fall River-Greater New Bedford area physicians within the rapidly expanding Steward Health Care Network, along with Saint Anne’s Hospital, will be at the forefront of a major statewide restructuring of the MassHealth program aimed at further improving care coordination and outcomes for MassHealth patients.

Hundreds of physicians in the Fall River-New Bedford area will participate in Steward Health Choice.

Effective March 1, 2018, Accountable Care Organizations (ACOs) like those originally pioneered within the Steward Health Care Network for Medicare and commercial patients will now be available to help improve the experience and outcomes of MassHealth members. This ACO model is being adopted by Steward and several providers across the state.

“We are excited to welcome MassHealth patients into our new ACO plan, Steward Health Choice,” said Dr. Mark Girard, president of Steward Health Care Network. “It’s wonderful that the MassHealth patients in the Fall River-New Bedford area and at Saint Anne’s Hospital will have access to this superior form of health coverage that for too long was limited only to Medicare and commercial patients. We applaud the state for these reforms.”

More information is available at https://stewardhealthchoice.org.

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Steward Health Care Network (SHCN) provides world class care to more than two million patients annually. SHCN's approximately 4,800 providers include both primary care physicians and a full range of specialists who are committed to meeting the needs of our patients. Established in 2008 as the physician network for the hospitals of Steward Health Care System, SHCN extends across ten states and takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians and hospitals across the continuum of care. In addition, SHCN promotes care coordination and collaboration within the network in order to provide high quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where you live.

The network is also responsible for the implementation and execution of Steward’s managed care contracts, medical management services, quality improvement programs, data analysis and information services.

About Saint Anne’s Hospital: A member of Steward Health Care, Saint Anne’s Hospital in Fall River, Massachusetts, is a full-service, acute care Catholic hospital with 185 beds and satellite locations in Attleboro, Swansea, Dartmouth, New Bedford, and Stoughton, Massachusetts. Founded by the Dominican Sisters of the Presentation in 1906, Saint Anne’s provides nationally recognized patient- and family-centered inpatient care (including all private rooms) and outpatient clinical services to patients from surrounding Massachusetts and Rhode Island communities. In addition to comprehensive diagnostic, medical, surgical, and emergency services, Saint Anne’s key services include the Fernandes Center for Children & Families; Joint Commission-certified Center for Orthopedic Excellence; Saint Anne’s Hospital Regional Cancer Center; ambulatory surgery centers in Attleboro and Dartmouth; the Center for Pain Management in Swansea and Dartmouth; and geriatric psychiatry services at locations in Fall River and Stoughton.

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Additional background on the new ACO options available for MassHealth patients:

The new ACO reforms support MassHealth’s commitment to:

  • Improve quality and member experience and integrate the full spectrum of care including medical care, behavioral health and long term services and supports (LTSS)
  • Provide clinical and  community based support for populations with behavioral health and long term health care needs
  • Shift incentives to hold providers accountable for quality and total cost of care for a population of patients
  • Invest in primary care and community workforce development
  • Allow for innovative ways of addressing the social determinants of health
  • Expand access to substance misuse disorder treatment, including treatment for co-occurring disorders.

The state’s ACO program is a major component in its five-year innovative 1115 Medicaid waiver bringing in $1.8 billion in new federal investments to restructure the current MassHealth system. ACOs will receive more than $100 million in new investments throughout the remainder of 2017 to support the transition of health care providers providing value-based care. Funds will be used to:

  • Improve electronic health records and ACO analytic capabilities,
  • Reduce avoidable inpatient and emergency department utilization
  • Implement other key initiatives for ACOs to improve health outcomes and member experience under the new payment models.

Member enrollment in ACOs will be based upon their relationship with their current primary care provider to ensure continuity of care.  All ACO models support MassHealth’s commitment to invest in community based organizations, referred to as certified community partners for behavioral health and long term services and supports.

Additional information on MassHealth’s planned restructuring and payment reforms for its 1.9 million members may be found on the MassHealth Innovations website at www.mass.gov/hhs/masshealth-innovations.

The development and implementation of the ACO program is being supported by Funding Opportunity Number CMS-1G1-12-001 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

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