Release Date: 08/30/2016
The Centers for Medicare & Medicaid Services (CMS) today announced the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model that show physicians, hospitals and health care providers participating in Accountable Care Organizations continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.
In 2015, Medicare Accountable Care Organizations had combined total program savings of $466 million, which includes all Accountable Care Organizations’ experiences, for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more Accountable Care Organizations shared savings in 2015 compared to 2014, and those with more experience tend to perform better over time.
Medicare ACOs are groups of doctors, hospitals, and other health care 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 health care dollars – it is able to share in the savings generated for Medicare.
In addition to those ACOs that shared 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 they did not earn a performance payment.
“Thanks to our comprehensive Complex Care Management program – which includes nurse care managers, nurse practitioners, social workers, and more – and Integra’s strong network of primary care practices and specialists, we provided more than 13,000 Medicare patients high quality, coordinated care and achieved a significant savings in our very first year of operation,” said Integra Chief Clinical Officer James E. Fanale, MD.
“On total spending of more than $152 million, we achieved a savings just short of $4 million,” added Fanale. “This is a truly significant accomplishment and bodes well for the future of Integra, our partners, and the payment reform efforts in Rhode Island in which Integra participates.”
“At the same time we reduced spending compared to the benchmark, we made great strides strengthening the quality of care being delivered by providers across Integra,” said Albert Puerini, MD, president and CEO of RI Primary Care Physicians Corporation (RIPCPC), and Chairman of the Board of Integra Community Care Network, LLC. “We are at or above the national average in most areas, scoring higher than the than national average in 22 out of the 34 measures.”
Visit the Medicare Shared Savings Program News and Updates webpage to access the CMS press release and fact sheet, the link to the Performance Year 2015 results file, and to learn more about the program.
About Integra Community Care Network, LLC
Integra Community Care Network is a CMS certified ACO with more than 120,000 covered lives. Its participating provider network includes Rhode Island Primary Care Physician Corporation (RIPCPC), Care New England and South County Hospital and employed and affiliated physicians. Integra was also named as an Accountable Entity by the RI Executive Office of HHS and assumed responsibility for more than 30,000 Rite Care participants, effective January 1, 2016.