While federal accountable care organization (ACO) program results from 2015 exposed another year of mixed outcomes, Premier, Inc. has just released data showing that its ACO participants continue to outpace their peers.
In August, the Centers for Medicare & Medicaid Services (CMS) released its annual report on how ACOs performed in two federal programs—the Pioneer ACO Model and the Medicare Shared Savings Program (MSSP) model. In sum, while more than 400 Medicare accountable care organizations generated more than $466 million in total program savings in 2015, nearly seven in 10 of those ACO organizations (30 percent) did not generate enough savings to receive bonuses.
But Premier, the Charlotte, N.C.-based healthcare improvement company, said that half of the ACOs in its Population Health Management Collaborative (PHMC) were able to receive shared savings payments for the second year in a row. Indeed, a Premier analysis suggested if every Medicare ACO achieved the cost and quality performance of PHMC Medicare ACOs, approximately $1.36 billion could have been saved in 2015 alone—nearly three times more than the $466 million in total savings realized by all 404 Medicare ACOs.
Created at the start of 2010, the PHMC includes approximately 450 hospitals and thousands of clinicians that aim to work together to align, measure and improve population health management. Making up six percent of all program participants, PHMC Medicare ACOs have contributed to 22 percent of the $1.29 billion in total Medicare savings since 2012. Additionally, 80 percent of the PHMC Medicare ACO members that started in 2012 achieved shared savings in 2015 compared to 42 percent of 2012 starters nationally.
In 2015, PHMC Medicare ACOs also achieved higher than average quality scores, even though there was a large jump in Medicare ACO quality scores nationally. PHMC Medicare ACOs achieved scores of 93.8 percent versus 91.5 percent nationally—outperforming by 2.3 percentage points, a 6.5 percent improvement compared to 2014. This includes achieving superior performance in more than half of the quality measures when compared to other Medicare ACOs, Premier officials noted.
“PHMC members have demonstrated that smart planning, active physician leadership and professionally-managed implementation drives sustained quality and population health improvement,” Joe Damore, vice president of population health at Premier, said in a statement. “These results are critical, particularly now that many providers are evaluating advanced alternative payment models under the Medicare Access and CHIP Reauthorization Act (MACRA). Even with benchmarks that are lower than the national average, these health system-sponsored ACOs are making an impact in a wide variety of communities across America and bending the healthcare cost curve.”
Get the latest information on Finance and Revenues and attend other valuable sessions at this two-day Summit providing healthcare leaders with educational content, insightful debate and dialogue on the future of healthcare and technology.