Virtua Medical Group, PA

Virtua Medical Group, PA is part of the CMS Medicare Shared Savings Program

Young male physician in white lab coat shows plastic medical item to older male patient who is seated on table

Virtua Medical Group, PA participates in the CMS Medicare Shared Savings Program (MSSP), an Accountable Care Organization (ACO) initiative designed to improve care coordination for Medicare beneficiaries while lowering costs. As part of this program, Virtua Medical Group, PA focuses on high-quality care to generate potential shared savings, with performance results reported to CMS. The goal of the MSSP is to deliver coordinated, high-quality care and to improve health outcomes for patients with Medicare. As an ACO participant, Virtua Medical Group, PA agrees to be accountable for the quality, cost, and patient experience of their assigned beneficiaries.

 

What is an Accountable Care Organization (ACO)?

An ACO is a healthcare organization with a payment and care delivery model that seeks to achieve quality metrics and reduce the total costs of care for an assigned population of patients.  ACOs, such as Virtua Medical Group, are accountable to patients and third-party payers for the quality, appropriateness, and efficiency of the healthcare provided. According to the Centers for Medicare and Medicaid Services (CMS), an ACO is “an organization of healthcare providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.”

Virtua Medical Group, PA helps to coordinate care

By communicating more closely with beneficiaries and other healthcare providers, ACOs such as Virtua Medical Group, PA are able to deliver better coordinated care to meet individual needs and preferences.

Benefits of an ACO

ACOs focus on preventative, coordinated care to keep costs low. ACOs can share in the savings they achieve for third-party payers such as Medicare when the ACOs succeed in delivering high-quality care. ACOs must meet specific quality metrics to share in these savings.

Quality Metrics

What is measured is managed. Medicare and participating third-party payers have developed quality metrics for measuring performance in improving health care quality. Areas of focus include:

  • Patient experience
  • Care coordination
  • Patient safety
  • Preventative health

Provider Participants

All members of Virtua Medical Group, and their affiliates, participate in its ACO (Virtua Medical Group PA) in a group practice arrangement. The Group does not participate in any joint venture.

Key Clinical and Administrative Leadership

  • ACO Executive: Maryann Graham
  • Medical Director: Mary Campagnolo, MD
  • VMG ACO Compliance Official: Annette Albano*
  • Quality Assurance/Improvement Officer: Mary Campagnolo, MD

*The VMG ACO compliance official serves within the operations and leadership team for the ACO, in accordance with 42 CFR 425.300 (a) The ACO must have a compliance plan that includes at least the following elements: (1) A designated compliance official or individual who is not legal counsel to the ACO and reports directly to the ACO's governing body.

The Virtua Health Compliance Officer, serving the Virtua Health System and all its entities, is Susan Hatch.

Information for Participants

If my physician participates in an ACO, does that change my Medicare Benefits?

No. Beneficiaries’ Medicare benefits will not change under the ACO model of care. ACOs are not a Medicare Advantage Plan, an HMO plan, or an insurance plan. Beneficiaries maintain the right to use any doctor or hospital that accepts Medicare at any time.

Can I decline to share my medical information with Virtua Medical Group, PA

Virtua Medical Group, PA values beneficiaries’ privacy and respects beneficiaries’ choices on the use of their personal health information for care coordination and quality improvement.

Beneficiaries can ask Medicare not to share information with Virtua Medical Group, PA or other ACOs for care coordination and quality improvement purposes by doing one of the following:

  • Complete, sign, and return the “Declining to Share Personal Health Information” form found in your doctor’s office.
  • Call 1-800-MEDICARE (1-800-633-4227). Be sure to tell the Medicare representative that you are calling about ACOs. TTY users should call 1-877-486-2048.

If I have questions about ACOs or Virtua Medical Group, PA, who do I contact?

  • Beneficiaries may call the Virtua Medical Group, PA Quality team at 856-325-3319 or make an appointment to see your Virtua Medical Group, PA primary care clinician and mention your questions or concerns during your next visit.
  • You can also call 1-800-MEDICARE and tell the representative that you are calling about ACOs or visit www.medicare.gov/acos.html .

Contact Information
Primary Contact: Maryann Graham
Virtua Medical Group, PA
301 Lippincott Drive, Suite 410
Marlton, NJ, 08053
Phone: 856-325-3319