4 minute read

Improving Quality and Outcomes While Reducing $136M in Medicare

Learn how 14 Medicare Shared Savings Program ACOs received an average quality score of 98% and saved Medicare more than $200 million over three years.

14 Medicare Shared Savings Program ACOs received an average quality score of 98%;
saved Medicare more than $200 million over three years

Chicago, Ill.—August 26, 2021—CommonSpirit Health, one of the nation’s largest providers of value-based care, announced today that it delivered improved quality and $136 million in savings to Medicare for the 2020 performance year of the Medicare Shared Savings Program (MSSP). The program was designed by the Centers for Medicare and Medicaid Services (CMS) to improve care for patients and populations, while making health care more affordable. Through its 14 accountable care organizations (ACOs), CommonSpirit improved care outcomes for approximately 335,000 Medicare beneficiaries with an average quality score of 98%.

“Despite the extraordinary challenges the pandemic has posed over the past year, with many patients unable or hesitant to access care, CommonSpirit’s ACO care teams tripled our care coordination engagement and achieved outstanding quality scores,” said Executive Vice President of Physician Enterprise Dr. Thomas McGinn. “I am proud of their work to proactively engage our patients, especially those most vulnerable and at high-risk, and improve the health and well-being of the communities we serve.”

Over the past three years of participating in MSSP, CommonSpirit has saved Medicare more than $200 million. The savings and care quality improvements are a result of prioritizing connections with patients and deploying a suite of innovative programs to address unmet medical, behavioral and social needs. CommonSpirit’s care improvement strategies focus on proactive outreach and transition of care: increasing annual wellness visits, managing hypertension, innovating home health offerings and improving care coordination across the care continuum.

“Many of these long-standing initiatives were accelerated in 2020 as their importance was brought into starker relief by the pandemic. As a result, our ACOs ramped up to provide 12% more annual wellness visits than the previous year for high-risk patients, while continuing to make gains in chronic disease management,” said Dr. McGinn.

Another key focus area throughout the pandemic has been navigating vulnerable patients – including those hospitalized with COVID-19 – through high-risk transitions of care. Post-acute care coordinators ensure screening for social determinants of health, and collaborate with community post-acute facilities to identify bed availability and placement capacity. Care coordination teams also coordinate with medical equipment vendors to ensure patients who need home oxygen receive it, while Home Health provides intensive rehabilitation and skilled nursing services leveraging both in-home and virtual telehealth visits.

Many of CommonSpirit’s local ACOs realized significant savings and saw strong quality scores. Examples include:

Rainier Health Network in Washington provided care for over 38K Medicare beneficiaries, and saved Medicare $20.4 million while improving their quality score to 97%.

Arkansas Health Network provided care for over 30K Medicare beneficiaries and saved Medicare $14.3 million while improving their quality score to 98%.

Baylor St. Luke’s Health Network in Texas provided care for over 16K Medicare beneficiaries and saved Medicare $17.6 million while improving their quality score to 97%.

Alegent Health Partners in Nebraska provided care for almost 19K Medicare beneficiaries and saved Medicare $13.4 million while improving their quality score to 97%.

Dignity Health Care Network in California and Nevada provided care for over 70K Medicare beneficiaries and saved Medicare $37.5 million in its first year.

Mission Health Care Network (TN), MercyOne ACOs (IA), CHI Saint Joseph Health Partners (KY), St. Joseph Health Partners (TX) and North Central Arizona Accountable Care (AZ) together provided care for over 155K Medicare beneficiaries and saved Medicare $32.4 million.

Overall, CommonSpirit ACOs achieved a higher savings rate and quality score in 2020 than the national average. The average CommonSpirit ACO also saved Medicare $9.3M, surpassing other average ACOs by $1.3M.

In addition to the MSSP, CommonSpirit participates in the NextGen ACO program, along with other innovative payment models, in an effort to deliver patient value through better care and improved quality. NextGen quality and savings results will be released later in the year.

###

About CommonSpirit Health
CommonSpirit Health is a nonprofit, Catholic health system dedicated to advancing health for all people. It was created in February 2019 by Catholic Health Initiatives and Dignity Health. CommonSpirit is committed to creating healthier communities, delivering exceptional patient care, and ensuring every person has access to quality health care. With a team of approximately 150,000 employees and 25,000 physicians and advanced practice clinicians, CommonSpirit Health operates 140 hospitals and more than 1,000 care sites across 21 states. Learn more at www.commonspirit.org.