With 40 member medical practices and slightly more than 12,000 patient lives under management, Boynton Beach based Accountable Care Options (www.ACO-FL.com
) isn’t the largest Accountable Care Organization (ACO) in Florida, nor does it strive to be. “Certainly that’s one strategy,” concedes Richard Lucibella, MHS, MBA, Director and CEO of the four year old company. “You could try to get real big, real fast with a goal of achieving economies of scale. For us though, it just made sense to grow steadily with quality-focused, like-minded physician partners.”
This strategy appears to be paying off. Three contract years are in the books (2012/2013, 2014 and 2015) and all have resulted in shared savings. “Our PCPs split $7 million in shared savings with the network last year and we are on track for continued success this year,” states Mr. Lucibella. Talk about the Triple Aim among healthcare professionals and you will often be greeted with a cynical look of resignation or perhaps outright derision. Not so with Mr. Lucibella who enthusiastically states that “The Triple Aim is not a pie in the sky goal. We are expanding the definition of medicine to what it should be.” A graduate of University of Pennsylvania’s Wharton School, Mr. Lucibella began his career with the Health Care Financing Administration (Medicare) and was directly involved in the original Medicare HMO risk projects. He has been active in South Florida Medicare risk programs since the mid 1980’s.
As to the future, Mr. Lucibella is quite blunt. “We are aggressively taking on risk. Payer’s don’t want it and most practitioners can’t bear it. But we know how to manage it and profit from it,” he states. Although many primary care doctors fear the good old days are over, the shift to value based care will be a boon to primary care practitioners, according to Mr. Lucibella. “This is revenge of the PCP,” he asserts. Taking additional risk allows Accountable Care Options a SNF waiver, a tele-health waiver and potentially a post acute care waiver. These concessions create resources that can be devoted to expanding chronic care management programs that end up reducing cost in the long run. “If it serves the Triple Aim, the government is going to OK it. This is the smartest CMS we’ve had in thirty years,” states Mr. Lucibella.
Mr. Lucibella is particularly excited about their newly developed ‘Chronic Care Management Program on Steroids’ that targets the 5% of their patient population at highest risk. The full arsenal of resources, including physicians, NPs/PAs, nurses, MAs, behavioral health professionals, pharmacists (through a partnership with Nova Southeastern University), paramedics, palliative care professionals and (soon) nutritionists, is deployed.
With skepticism rampant in today’s health industry I had to ask Mr. Lucibella if he really believed we could bend the cost curve. “Absolutely,” was his immediate reply. “We are also going to bend the quality curve.”
EDITOR’S NOTE: We first interviewed Mr. Lucibella in 2014. You can read that article HERE