CVS Health, Catholic Health collaborate to increase health care access and value-based care for Long Island Medicare patients

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CVS Accountable Care Organization, Inc., a division of the CVS Health® family of businesses, announced it has entered into a collaboration with Catholic Health and Catholic Health Physician Partner’s ACO (Catholic Health) to expand value-based care and health care access for Medicare beneficiaries across the Catholic Health Physician Network in the New York area. The partnership builds on Catholic Health’s ACOs program, improving care for over 40,000 Medicare beneficiaries in Nassau and Suffolk counties and saving millions of dollars by meeting quality and total cost of care goals.

Catholic Health and CVS Accountable Care (CVS ACO) will jointly assume accountability for the health care of nearly 40,000 Medicare fee-for-service beneficiaries under the ACO Realizing Equity, Access, and Community Health (REACH) program1. The new collaboration, the first of its kind on Long Island, will help to strengthen care coordination for patients by providing customized support, such as home-based care, transportation support for annual wellness visits and linkages to services for addressing social determinants of health. Additionally, it will help improve support for Catholic Health providers, especially primary care providers; enhance the health system’s care delivery service offerings, including adding same-day access, multidisciplinary chronic condition care management programs and analytics to allow physicians to provide top-of-license care; and utilize innovative value-based payments to incentivize providers.

The agreement is based on the Centers for Medicare & Medicaid Innovation’s (CMMI) redesigned direct contracting model, ACO REACH. ACO REACH prioritizes health equity, the coordination of care among health care providers to improve outcomes, and the reduction of unnecessary medical costs by moving patients toward value-based care.

“Catholic Health looks forward to working with CVS ACO and bringing these important care enhancements to our Medicare population,” said Catholic Health President & CEO Patrick O’Shaughnessy, DO, MBA, noting the health system is the only Long Island-area participant in the CVS Accountable Care ACO REACH program. “As CVS’s exclusive health system partner in the Long Island market, we will be able to reach more patients as a unified resource and will provide new equity-focused clinical programs and services at a time when access to high-quality health care is more important than ever.”

“We know value-based care, particularly for Medicare beneficiaries, can help dramatically improve outcomes for patients who need it most and achieve lower costs,” said Mohamed Diab, MD, CEO, CVS Accountable Care Organization. “That’s why value-based care as a framework is central to our broader care delivery strategy. CVS ACO is bringing to the table powerful tools to help provide coordinated, high-quality care to Medicare patients.”

Diab noted the ACO REACH program enables CVS ACO to employ community-based assets such as MinuteClinic® retail health clinics, as well as the company’s robust data analytics and connected electronic medical record technology to support providers as they care for their most complex patients. The program also assumes administrative tasks such as appointment and lab scheduling assistance and provides actionable insights at the point-of-care to help providers offer more personalized patient care. Overall, the partnership allows for more integration, data sharing and care coordination resulting in less fragmentation and ultimately the goal of better outcomes.

The collaboration builds on Catholic Health’s Physician Partner’s ACOs successes in the Medicare Shared Savings Program to ensure patients have access to equitable, accessible and high-quality care.

Both CVS Health and Catholic Health have longstanding commitments to reducing health disparities that contribute to unequal health outcomes. “CVS Health is focused on advancing health equity for our customers, colleagues, clients and communities by improving health care access and quality of health for every patient we serve,” said Diab.

“At Catholic Health, we are grounded in our humanity and dedicated to the transformation of health care,” said O’Shaughnessy. “We remain dedicated to making a critical difference in the health trajectory of the underserved and to enhancing the care in the communities most in need. That is what health equity is all about.”

Catholic Health will join a growing national network of leading and diverse providers working within the CVS ACO framework to care for Medicare beneficiaries. This network includes other clinically integrated networks, primary care groups and Federally Qualified Health Centers.