Collaborative Health Systems ACOs Generate $389 Million in Medicare Savings Since 2012

Through innovative ACO models, providers are improving quality outcomes and reducing costs

TAMPA, Fla. (Jan. 13, 2021) – Collaborative Health Systems (CHS) announced today that it helped Medicare healthcare providers generate $389 million in total savings through Accountable Care Organization (ACO) models since 2012, according to figures released by the Centers for Medicare & Medicaid Services (CMS). Performance year 2019 marks the eighth consecutive year that CHS – one of the largest Medicare ACO sponsors in the country – generated savings to Medicare.

CHS helps healthcare providers serving the Medicare population organize and improve the quality, cost, and experience for Medicare beneficiaries through value-based models such as the Medicare Shared Savings Program (MSSP) – including the redesigned model, Pathways to Success – and the Next Generation ACO Model. In total, 91% of CHS ACOs delivered savings to Medicare. During 2019, CHS supported nine MSSP ACOs, as well as two Next Generation ACOs to help them:

• Deliver coordinated, high-quality care to 131,000 Medicare beneficiaries nationwide;
• Generate $17.6 million in MSSP shared savings; and,
• Generate $33.2 million in Next Generation shared savings.

CHS-supported MSSP ACOs have generated a total of $183 million in shared savings since 2012, and CHS-supported Next Generation ACOs have generated a total of $54.2 million in shared savings since 2017.

“Healthcare providers serving the Medicare population are using innovative care models to increase collaboration and enhance the delivery of quality care, which helps reduce healthcare costs,” said Anthony Valdés, President of Collaborative Health Systems. “The results achieved through our collaborative provider partnerships firmly demonstrate how value-based care models benefit consumers, providers, and taxpayers.”

“The ACO model provides a framework for efficient, and more importantly, effective healthcare spending,” said Michael Polen, Senior Vice President and CEO of Medicare Solutions for Centene Corporation. “Collaborative Health Systems offers the structure, guidance, and resources to help providers transition to value-based models, all while improving the quality of care for Medicare beneficiaries.”

In addition to cost savings, CHS-supported ACOs achieved an average quality score of 94.6%, meaning they improved the quality of care for Medicare beneficiaries through measures such as:

• A 5.5% increase in services by primary care providers;
• A 4.8% reduction in acute hospitalizations, meaning less people going to the hospital;
• A 4.3% reduction in emergency room visits; and,
• An 18.3% reduction in days spent in skilled nursing facilities.

CHS works with providers in ACOs in the following regions:

• Connecticut
• Georgia
• Maryland, Virginia, and Washington, DC
• New Jersey
• New York
• South Carolina
• Tennessee
• Texas
• Wisconsin

Medicare ACOs are groups of doctors, hospitals, and other healthcare providers who come together voluntarily to provide coordinated, high-quality care to their Medicare beneficiaries. The MSSP is a legacy model that offers providers and suppliers an opportunity to create an ACO, which agrees to be held accountable for the quality, cost, and experience of care of an assigned Medicare Fee-For-Service beneficiary population. Pathways to Success is a redesigned version of the MSSP program where providers manage increasing levels of financial accountability over time, shifting the focus from traditional fee-for-service (FFS) reimbursements and holding providers to higher standards of quality and performance. The Next Generation ACO Model was designed under the CMS Innovation Center to test whether strong financial incentives for ACOs can improve health outcomes and reduce expenditures for Medicare FFS beneficiaries. Provider groups in this Model assume higher levels of financial risk and reward than are available under the MSSP.