Stephen Nuckolls Discusses the Evolution of Coastal Carolina Quality Care's ACO Model

Stephen Nuckolls, CEO of Coastal Carolina Quality Care, explained during his presentation at the National Association of Accountable Care Organizations Spring 2016 Conference that the more physicians read and learn about value-based care, the more they are accepting the change. He added that as the idea has become more accepted, accountable care organizations (ACOs) are beginning to evolve as well.

Transcript (slightly modified)

Is it getting easier to sell physicians on the idea of ACOs and value-based care?

It definitely is. Our physicians and our group, they definitely follow some of the media and the journals that they read and they know that Medicare must move to more of a value-based world. And so the more things that they read, I think they feel more comfortable with it. Our organization has been at this awhile. We were one of the first 27 ACOs and one of the first 5 that were named as an advancement payment model so they’ve been at it for a while.

I think it definitely helps with MACRA [Medicare Access and CHIP Reauthorization Act] and some of the other new initiatives coming down the pipe. I think that it helps with engagement to know that they really need to focus on the efforts that we have and expand to new efforts from the ones that we’ve done in the past.

As one of the first ACOs, what have been your big lessons learned over the last few years?

Well, it’s been a constant evolution. We start off with the advanced payment funds, which allowed us to provide a very robust care coordination program. Since we did not achieve savings, we transitioned to the CCM, or chronic care management, codes that CMS afforded at the beginning of 2015. So we’ve had to change our program.

With that change came a lot of different focus on our efforts. Also, as we have evolved over time some of the quality measures and areas of focus in the beginning, we’ve reached our goals and so we have moved on to other measures that needed more attention. So the focus in some cases has moved from what I would call the process measures and to more outcomes measures in the last year or so.