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Kelsey-Seybold Named Nation's First Accredited Accountable Care Organization

Receives Highest Achievable Level of Accreditation Available from NCQA

Houston (December 13, 2012) –The National Committee for Quality Assurance (NCQA) announced today that Kelsey-Seybold Clinic is the first U.S. healthcare organization to receive accreditation as an Accountable Care Organization (ACO) in the nation. Kelsey-Seybold was one of six organizations seeking ACO accreditation through the NCQA when it began accepting submissions in March 2012.

"We are honored to receive the first ACO accreditation," said Spencer R. Berthelsen, M.D., Chairman and Managing Director of Kelsey-Seybold Clinic. "It confirms our successful creation of a fully coordinated, accountable model of care at Kelsey-Seybold. We believe the model of care coordination, high-quality outcomes and efficiency has always been the future of healthcare."

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The NCQA Accountable Care Organization Accreditation is voluntary and evaluates an organization's ability to deliver coordinated, patient-centered care; to improve clinical quality; to enhance the patient experience; and to reduce costs through quality clinical practices. Being named an accredited ACO by the NCQA helps purchasers and providers identify effective partners. It also helps patients find physicians who are committed to providing the quality care they need, when they need it.

To receive accreditation, which is valid for three years, Kelsey-Seybold Clinic underwent a rigorous assessment that focused on the evaluation of 14 standards and 65 elements that include:

  • ACO Structure and Operations
  • Access to Needed Providers
  • Patient-Centered Primary Care
  • Care Management
  • Care Coordination and Transitions
  • Patient Rights and Responsibilities
  • Performance Reporting and Quality Improvement

The NCQA also collected data on key clinical and service measures such as mammography screening rates, comprehensive diabetes care and consumer satisfaction. Based on the comprehensive survey, NCQA assigns a level status to the organization.

"By being the first organization to earn NCQA ACO Accreditation, Kelsey-Seybold has demonstrated to payers and other purchasers that it has met challenging requirements designed to show the efficiency, integration and high quality expected of an accountable care organization. NCQA Accreditation also shows patients and providers that Kelsey-Seybold is prepared to deliver on the promise of better care on all these dimensions," said NCQA President Margaret E. O'Kane.

Kelsey-Seybold scored high marks under the accreditation review process and was named a Level 2 ACO – the highest level of achievement that can be reached in this first year of accreditation. Level 3 achievement calls for additional reporting and outcomes that cannot be measured in this early stage of the program.

For employers, the NCQA Accountable Care Organization Accreditation provides an unprecedented ability to evaluate the quality of ACOs across key service dimensions, and to make decisions based on demonstrated value rather than simply on fee-for-service cost. ACO accreditation helps determine if an organization has the infrastructure for accountability to patients and employers on outcomes of care and cost. ACOs provide coordinated services which are preventive and proactive in nature, often reducing the need for high-cost hospitalization episodes associated with catastrophic care.

"The achievement of this accreditation validates that we are well situated to deliver on the promise of what an ACO can deliver. According to NCQA's standards, as an accredited ACO, we will be a good partner to employers and 'most likely to succeed' because of how Kelsey-Seybold is organized to deliver care to our patients and cost efficiencies to employers and payers," Berthelsen concluded.

About the NCQA ACO Program:
The NCQA program contains many consumer protections and aligns with consumer protection principles outlined in the National Partnership for Women & Families' Campaign for Better Care. ACOs are generally defined as provider-based entities that aim to improve the quality of healthcare and reduce cost growth for a group of people. In order to have enough patients for quality reporting and managing financial risk, ACOs must serve at leave 5,000 patients a year.

About NCQA:
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

About Kelsey-Seybold

Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey in Houston's renowned Texas Medical Center. More than 850 physicians and allied health professionals practice at 40 locations in the Greater Houston area. Kelsey-Seybold offers quality medical care in 65+ medical specialties. The organization operates the largest freestanding Ambulatory Surgery Center in the state of Texas and offers state-of-the-art Varian TrueBeam and Varian Edge radiation therapy technology at a nationally accredited Cancer Center. An accredited Sleep Center, comprehensive laboratory services, advanced imaging and diagnostics, 24 onsite Kelsey pharmacies and one specialty pharmacy, and MyKelseyOnline, a secure web portal, are part of its comprehensive offerings. Kelsey-Seybold partners with major insurers to offer value-based commercial health plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold Clinic, has achieved the coveted 5-out-of-5-star rating from the Centers for Medicare and Medicaid for eight consecutive years.

Kelsey-Seybold has been recognized by the National Committee for Quality Assurance (NCQA) as the nation’s first accredited Accountable Care Organization and is home to a nationally accredited Breast Diagnostic Center and Endoscopy Center.

Kelsey-Seybold Clinic achieved a Net Promoter Score (NPS) of 91. NPS is the global standard for measuring customer loyalty and satisfaction. An NPS score of 70 or higher is considered by industry experts to be "world class" and an indicator of overwhelming customer loyalty.

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