Genesis Brings Almost 200 Outside Nursing, Long-Term Care Facilities into its ACO

Genesis HealthCare (NYSE: GEN) has made expanding its accountable care organization (ACO) a major growth goal for the coming decade, and the post-acute and long-term care giant ended the year by announcing close to 200 new additions — all from outside of the company.

The Kennett Square, Pa.-based Genesis late Monday disclosed that it had added that new crop of unaffiliated nursing and other long-term care facilities to its ACO, while also touting ongoing contracting discussions with 200 specialty doctors who provide care to residents of those properties.

The announcement marks the latest step in Genesis’s ongoing push to turn its ACO, which counts about 6,400 enrolled beneficiaries, from an in-house Medicare Shared Savings Program (MSSP) initiative to a more outward-facing organization: The company recently changed the entity’s name from the Genesis Healthcare ACO to the more inclusive LTC ACO, and the expansion announced this week will bring an additional 3,000 members to the ACO by the close of 2020, according to Genesis.

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“With nearly four years of participation under the MSSP, we are proud to share our valuable experience in driving better outcomes and improved quality, managing episodic and chronic costs while developing in-house capabilities to predict program performance,” LTC ACO president Jason Feuerman said in a statement. “It is a win-win for all parties and residents.”

The ACO concept — which encourages providers up and down the continuum to reduce spending through cross-provider collaboration — has long been a source of stress for skilled nursing providers. Many of the model’s biggest victories have come at the expense of SNF utilization, with one anonymous operator going so far as to call ACOs a “disaster” for the industry.

But Genesis has frequently pointed to its size and scale as an advantage in the ACO marketplace. The provider has been able to use its Genesis Physician Services division, for instance, as a catalyst for ACO growth and success, deploying doctors into nursing homes to achieve savings by avoiding rehospitalizations — and not cutting out SNFs entirely.

LTC ACO reported $1.7 million in savings-related bonus payments from the Centers for Medicare & Medicaid Services (CMS) in the third quarter of 2018, with Feuerman and CEO George Hager telling SNN earlier this year that the ACO represents a better opportunity for the company than the red-hot Institutional Special Needs Plan (I-SNP) model.

Instead of assuming the financial burdens of starting an I-SNP, a special kind of Medicare Advantage plan that has received increased attention in recent years, Feuerman and Hager believe that Genesis can achieve similar goals — caring for residents in place, and reducing readmission rates — through the ACO.

“We just believe that even though there’s pluses and minuses to each program, there are some things that make the ACO potentially slightly easier to implement and administer, and maybe even to grow,” Hager said.

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