Holyoke Medical Center (HMC) has announced the promotion of South Hadley native John Kovalchik, LICSW, as Director of ACO Operations.
With extensive experience leading healthcare management initiatives (most recently as Manager of the Center for Behavioral Health at HMC), Kovalchik is well-positioned to bring our community Medical Center to the next level by improving quality of care: meeting measurable benchmarks, accurately reflecting the hospital’s population’s health risks, and maintaining lower overall healthcare costs— all mandates of value-based ACO models.
“We are thrilled to welcome John to this key role,” said Spiros Hatiras, President & CEO of Holyoke Medical Center and Valley Health Systems, Inc. “John brings a wealth of experience to this position and an enthusiasm for integrating the management of patient care and cost-saving initiatives which are vital to our community.”
ACO is an acronym that stands for Accountable Care Organizations (“ACO”), which are provider-led organizations that support new federal and state initiatives shifting from the previous model of fee-for-service based healthcare to a value-based system that puts more of the risk on the provider, Kovalchik explained. The overall goals of ACOs are to improve quality of care and patient health outcomes by meeting measurable benchmarks, ensure patients are accessing healthcare at the appropriate levels and controlling the overall costs of healthcare by working within population-based models.
In his new position, Kovalchik is overseeing management initiatives for the two ACOs in which HMC participates. The first is through a unique partnership with UMass Memorial Medical Center, involving 50,000 lives split amongst seven hospitals, four federally qualified health centers and several private physicians’ offices, covering central and western Massachusetts (since 2016). The second is a state-wide ACO participating in a major new demonstration to support a value-based restructuring of MassHealth’s health care delivery and payment system. For this initiative HMC partners with BACO, the Boston Accountable Care Organization and BMC Healthnet Plan to form an ACO named the BMC Healthnet Plan Community Alliance.
The UMass ACO deals primarily with patients on Medicare (typically older adults), while the BMC Healthnet Community Alliance ACO manages the population health needs of those receiving MassHealth benefits, from children to adults. Both groups are often at risk for complications from diagnoses including Diabetes, Chronic Obstructive Pulmonary Disorder (COPD), heart disease, obesity, substance use and mental illness.
Among the dozens of ACO quality benchmarks are things like ensuring appropriate follow-up care post hospitalization, avoiding unnecessary trips to the Emergency Department, receiving immunizations, controlling high blood pressure, controlling asthma, receiving medications as prescribed on time and ensuring appropriate follow-up care for patients with mental illness upon leaving an inpatient psychiatric unit. Nationally, there are 923 ACOs, and that number increases every year, he said.
Kovalchik is also overseeing HMC’s $750,000 CHART grant from the Health Policy Commission which provides medication assisted treatment (MAT) to patients struggling with opiate addiction with the goal of preventing recidivism and “helping patients to survive and thrive,” he said.
“System change is very exciting, and this is all in the service of providing great and more efficient healthcare,” said Kovalchik, who holds a master’s degree in social work from the University of Connecticut, with a focus on healthcare administration, and has directed clinical programming and served in management roles at several local organizations. In his previous role as Manager of Behavioral Health at HMC, he participated in ACO planning discussions and sees his new position as a natural transition.
“A significant portion of our patients fall into one of the public-payer buckets (Medicare and MassHealth). We have a great team of dedicated nurses, patient navigators, quality/analytic professionals, community health workers and physicians helping these patient populations on a daily basis. We also help people with housing, nutrition, obesity, food insecurity ... we’re trying to get people to the right levels of care at the right time, and control the ever-rising costs of healthcare,” he said.
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