Leaders at the Charlotte-based Premier Inc. on Sep. 28 were able to boast about the strong generation of savings for the Medicare Program, through the participation of member accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP) in calendar year 2019.
In a press release published to the health alliance’s website on Monday morning, Premier leaders reported that “Three quarters (75 percent) of Premier Population Health Management Collaborative (PHMC) accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) earned savings for the government, according to results released by the Centers for Medicare & Medicaid Services (CMS) last week. Of those, 44 percent performed well enough to qualify for shared savings payments from Medicare. These results outpace the national averages for comparable ACOs, which generated savings and shared savings at a rate of 70 percent and 40 percent, respectively. Additionally, PHMC MSSP ACOs participating in two-sided risk generated savings at a slightly higher rate when compared to all two-sided risk ACOs nationally (90.91 percent, compared to 90.71 percent). In total, PHMC members have generated net savings of $716 million over the course of five years, almost half of which ($323.6 million) was generated in 2019 alone,” Premier noted. The Collaborative encompasses about 450 hospitals and “tens of thousands of clinicians across 80 markets working together to align, measure, and improve population health,” according to Premier.
And the press release quoted Seth Edwards, vice president of strategy, innovation and population at Premier, and the leader of the Premier Population Health Management Collaborative. “Achieving success in Medicare ACO models is difficult work with complex variables at play, and PHMC ACO members are consistently proving that establishing a well-planned, value-based care delivery process and model leads to success,” Edwards said in the statement. “These results are a testament to the high-performance culture that the collaborative has helped hardwire into the DNA of these ACOs. We congratulate the PHMC members on their steadfast commitment and these impressive results. These shared savings will be critical to ongoing care redesign, particularly now that health systems are being tapped as first responders in the COVID-19 pandemic.”
What’s more, Edwards said, “PHMC members are true heroes of the pandemic, bringing all their sophisticated resources to bear to manage health and improve their communities. Their efforts should be recognized and rewarded. It should not be harder for these systems to achieve financial success in the MSSP, and health system ACOs should be on a level playing field with physician-led ACOs.”
The press release noted that, “Currently, physician-led ACOs are afforded more time in the Basic track and a lower overall exposure to payment risk, two significant advantages not afforded to health system ACOs.” In that regard, Edwards said, “The goal of ACOs is to cost effectively manage and deliver appropriate care across settings – not prevent care in any specific setting. ACOs that are incented to focus on one provider group’s success over another’s risk recreating the perverse incentives of fee-for-service, pitting providers against one another rather than encouraging cross-continuum collaboration.”
