Year-over-year (YOY), SHP doubled its earned shared savings and is the only Arizona MSSP ACO to receive a check from CMS for 2016 performance.
With a steady beneficiary pool of around 19,000 YOY, Scottsdale Health Partners generated savings of nearly $19 million, earned nearly $9 million in shared savings and received an overall quality score of nearly 97 percent.
CMS also reported on the performance of seven other Arizona ACOs that participated in the Medicare Shared Savings Program (MSSP) in 2016. Most earned overall quality scores above 90 percent. Some had very high overall quality scores, with the aforementioned SHP earning a 96.96% and Commonwealth earning a 96.42%. John C. Lincoln ACO and North Central Arizona Accountable Care earned 92.59% and 93.18 respectively.
Nationally, ACOs that participate in the MSSP program saved a total of $652 million. In Arizona, savings totaled more than $25 million from three ACOs: Scottsdale Health Partners, Arizona Care Network and ASPA – Connected Care. Nationally, 56 percent of MSSP ACOs cut their healthcare spending and 31 percent earned shared savings.
MSSP ACOs receive a unique benchmark target to care for Medicare beneficiaries and are rewarded when they can lower healthcare costs as they meet quality of care performance standards. All reporting is for Arizona MSSP ACOs participating under Track 1, a one-sided, shared saving model that provides shared savings payments for exceptional performance and is void of penalties for low quality scores or overspending.
Benchmark minus expenditure amounts represent losses or savings; the total benchmark expenditures minus the assigned beneficiary expenditures. Shared savings is available to ACOs with a savings rate equal or exceeding its minimum savings rate and meet the MSSP program’s quality performance standard.
Arizona MSSP ACO details are listed below:
Beneficiaries Served: 28,106
Quality Score: NR
Benchmark-Expenditures: -$2.2M Over Benchmark
Quality Score: 87%
Benchmark-Expenditures: $700K Savings
Arizona Care Network
Quality Score: 89%
Benchmark-Expenditures: $5.8M Savings
Arizona Connected Care
Quality Score: 88%
Benchmark-Expenditures: –$14.5M Over Benchmark
Commonwealth Primary Care ACO
Quality Score: 96%
Benchmark-Expenditures: -$138K Over Benchmark
John C. Lincoln ACO
Quality Score: 93%
Benchmark-Expenditures: -$27M Over Benchmark
North Central Arizona Accountable Care
Quality Score: 93%
Benchmark-Expenditures: –$7M Over Benchmark
Scottsdale Health Partners
Quality Score: 97%
Benchmark-Expenditures:$18.7M Savings. Earned Share: $8.8M
Source: 2016 MSSP ACO PUF File
Members of The Hertel Report will receive more information and data in the upcoming ACO Data Edition of The Hertel Report Newsletter.
Learn more about the national numbers from Fierce Healthcare
RevCycle Intelligence also has a recap of the national market.