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About this Webcast

​Every day in the United States, 10,000 people turn 65 and become Medicare eligible. These seniors often have multiple chronic conditions, which can lead to an Emergency Department visit and admittance to the hospital. The nationwide shift from volume-to-value in Medicare now incentivizes innovations in acute care delivery, particularly for older adults faced with multiple episodes of chronic disease exacerbation. 

In this interactive session, a Next Generation Accountable Care Organization (ACO) will share its experience developing a model for safe, cost-effective, home-based acute care to avoid hospitalization when it is safe to do so and when it corresponds to patients’ wishes. By providing an alternative to traditional hospital-based care, this new model may improve clinical outcomes and patient experience as well as enable long-term sustainability in a risk-based financial model.

Join this 1-hour Webcast on February 6, 2019 to learn about an ACO’s journey to develop a program that provides a rapid home-based response to acute events — one that is better matched to patient needs and can lead to better health outcomes. Lessons learned, challenges encountered, and success stories will all be shared during this session, helping participants develop their own models for acute care and adapt them to their own local constraints and resources.

What you’ll learn

By the end of this Webcast you’ll be able to:

  • Outline the journey of an ACO in developing an acute care in the home program
  • Summarize key lessons learned and challenges faced

This IHI webcast is approved for a total of 1 continuing education credit for nurses, physicians, health care executives, and quality professionals. It is also approved for 1 hour toward Certified Professional in Patient Safety recertification.


Ana Tuya Fulton Ana Tuya Fulton, MD, AGFS, FACP, an internist and geriatrician, joined the faculty of Brown University in 2006 and holds Associate Professorships in Medicine and in Psychiatry and Human Behavior. Dr. Fulton is Executive Chief of Geriatrics & Palliative care for Care New England health system, and Medical Director for Integra Community Care Network, LLC. Additionally, Dr. Fulton is the Care New England site director and Co-Project director for the Rhode Island Geriatric Workforce Enhancement Project (RI-GWEP). This is an HRSA-funded collaborative agreement to integrate geriatrics and primary care and to improve the care of older adults across Rhode Island. Her clinical and academic work focuses on improving serious illness care for persons with cognitive impairment as well as in integrating geriatrics best practices into primary care, hospital-based care, and accountable care entities. She has done multiple national presentations in these areas and has published over 26 peer reviewed articles.

John Minichiello John Minichiello, MBA, is the Executive Director of Integra Community Care Network in Rhode Island. Integra is a Medicare Next Generation ACO with more than 120,000 total covered Medicare, Medicaid, and Commercial ACO lives. John leads the ACO and is focused on performance improvement efforts within various population health initiatives, particularly spearheading efforts in the areas of complex care management, quality improvement, post-acute care management, shared decision making and social determinants of health. With over twenty years of experience working within care systems reimbursed by global payment and other value-based payment models, John has held leadership and management positions in several accountable care organizations (ACOs), integrated care delivery networks and health plans.

Mary Pisciotta Mary Pisciotta, MPH, Senior Project Manager,IHI, leads a number of projects and programs aligned with IHI’s Value Portfolio and serves as a co-lead for IHI’s Leadership Alliance Achieving Health Equity Workgroup. Ms. Pisciotta works closely with internal IHI teams, faculty, and customers to ensure delivery of the most effective and efficient programs and services to drive the improvement of health and health care outcomes worldwide. Prior to joining IHI, Ms. Pisciotta served as a Senior Quality Program Manager at a health plan, managing quality improvement projects designed to improve Medicaid members' quality of and access to care while ensuring compliance with State and Federal quality improvement program regulations. She also worked to establish, expand, and manage a federation-wide clinical quality improvement program for a national non-profit, serving over 700 clinics and over 5 million patients every year. Ms. Pisciotta received her Master of Public Health from Columbia University, with a Certificate in Social Determinants of Health.

Amy Stuck Amy Stuck, PhD, RN, is a program manager and health services researcher at the West Health Institute, a non-profit medical research organization conducting applied research focused on senior-specific healthcare delivery innovations to enable successful aging in place. Dr. Stuck earned her BSN at the University of Portland, her master’s degree at California State University, Dominguez Hills, and her PhD at the University of San Diego. She completed post-doctoral studies in the Department of Emergency Medicine at the University of California, San Diego. Dr. Stuck’s research expertise includes senior-focused emergency care, home and community-based alternatives to hospitalization, accountable and value-based care, delirium, opioid deaths and suicide. Dr. Stuck has over 30 years’ experience in Acute and Critical Care nursing, quality improvement, hospital leadership and nursing education.


Madge Kaplan Madge Kaplan, IHI’s Director of Communications, is responsible for developing new and innovative means for IHI to communicate the stories, leading examples of change, and policy implications emerging from the world of quality improvement ― both in the U.S. and internationally. Prior to joining IHI in July 2004, Ms. Kaplan spent 20 years as a broadcast journalist for public radio – most recently working as a health correspondent for National Public Radio. Ms. Kaplan was the creator and Senior Editor of Marketplace Radio's Health Desk at WGBH in Boston, and was a 1989/99 Kaiser Media Fellow in Health. She has produced numerous documentaries, and her reporting has been recognized by American Women in Radio and Television, Pew Charitable Trusts, American Academy of Nursing and Massachusetts Broadcasters Association.