Medicare ACOs Continue to Improve Quality of Care, Generate Shared Savings

August 27, 2015 01:53 PM

The Centers for Medicare & Medicaid Services issued 2014 quality and financial performance results showing that more Medicare Accountable Care Organizations (ACOs) continue to generate financial savings while improving the quality of care for Medicare beneficiaries by fostering greater collaboration between doctors, hospitals, and healthcare providers.

When an ACO demonstrates that it has achieved high-quality care and effectively reducing spending of healthcare dollars above certain thresholds, it is able to share in the savings generated for Medicare. In 2014, 20 Pioneer and 333 Shared Savings Program ACOs generated more than $411 million in savings, which includes all ACOs savings and losses. The results also show that ACOs with more experience in the program tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of healthcare dollars – it is able to share in the savings generated for Medicare.

HackensackAlliance ACO at Hackensack University Medical Center is one of the ACOs that generated shared savings.

“We are very pleased to announce that the HackensackAlliance ACO has generated an estimated $6.46 million in savings, covering more than 15,600 lives,” said Robert C. Garrett, president and chief executive officer of the Hackensack University Health Network. “Our focus on population health and caring for an entire community has been reflected in the ACO’s success.”

“To achieve cost savings two years in a row is a testament to the positive benefits of HackensackAlliance ACO,” said Morey Menacker, M.D., president of HackensackAlliance ACO. “We are proud that we will receive more than $2.8 million for our earned performance payment.”

In addition to those ACOs that generated savings, some ACOs had assigned beneficiary expenditures that were either greater than or less than their updated benchmark, but that fell within their minimum savings rate corridor. This means that theydid not earn a performance payment.

About Hackensack Physician-Hospital Alliance:

In April 2012, HackensackAlliance ACO announced it was one of the first 27 ACOs selected to participate in the Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organization (ACO), a multifaceted program sponsored by the Centers for Medicare and Medicaid Services (CMS). The ACO entered into an agreement with Medicare to take responsibility for the quality of care furnished to individual beneficiaries in return for the opportunity to share in any savings with the Medicare program for improved care. The ACO started with covering 13,000 lives and has now grown to 85,000. In September 2014, CMS announced that HackensackAlliance ACO has generated $10.75 million in savings and is receiving a $5.27 million payment for Earned Shared Savings.





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