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September 6 2016
 

Medicare Shared Savings Program Performance Year 2015

The Centers for Medicare & Medicaid Services (CMS) has 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 (ACOs) continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.

In 2015, Medicare ACOs had combined total program savings of $466 million, which includes all ACOs’ experiences, for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more ACOs 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.

ProHealth Solutions is one of the five ACOs in Wisconsin that generated savings above their minimum savings rate. Steve Kulick, MD, medical director and clinical integration chair for ProHealth Solutions, said focusing on quality goals throughout the organization was the leading factor in the local ACO’s results.

“At the core, our success can be attributed to the shared vision and efforts of our providers,” Kulick said. “Our collective actions as an ACO have allowed us to achieve a positive outcome while enhancing and efficiently managing the health of our patients.”

Kulick explained that several key initiatives played a role in the ACO’s success, including:

  • A single electronic patient record

  • Transparent communication

  • Staff support

  • Health coaches.

One electronic medical record provides seamless access to the data required to integrate and manage patient care, Kulick said. Communication between ProHealth Solutions’ staff and providers can identify and help close any gaps that might exist in a patient’s care. In addition, ACO staff work to ensure patients can access the care they need in the most appropriate setting. Finally, with health coaches in a number of primary care clinics, the ACO can efficiently coordinate the care of patients with complex health issues, Kulick explained.

Patient care and satisfaction are at the core of ProHealth Solution’s approach, Kulick said.

“I am most proud of the patient feedback we receive,” he said. “Our patients consistently rate our providers very highly for the level of care delivered and their communication.”

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.

 

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For more than a century, ProHealth Care has been the health care leader in Waukesha County and surrounding areas, providing outstanding care across a full spectrum of services. The people of ProHealth Care strive to continuously improve the health and well-being of the community by combining skill, compassion and innovation. The ProHealth family includes ProHealth Waukesha Memorial Hospital, ProHealth Oconomowoc Memorial Hospital, ProHealth Rehabilitation Hospital of Wisconsin, ProHealth Medical Group, the UW Cancer Center at ProHealth Care, Moreland Surgery Center, ProHealth AngelsGrace Hospice, ProHealth Home Care, ProHealth West Wood Health & Fitness Center and ProHealth Regency Senior Communities. Learn more at ProHealthCare.org.