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Medicare ACOs Continue to Improve Quality of Care, Generate Shared Savings


John Muir Health's Medicare ACO eligible to share in savings for second straight year

The Centers for Medicare & Medicaid Services issued 2014 quality and financial performance results showing that more Medicare Accountable Care Organizations (ACOs) continue to generate financial savings while improving the quality of care for Medicare beneficiaries by fostering greater collaboration between doctors, hospitals, and health care providers.

When an ACO demonstrates that it has achieved high-quality care and effectively reducing spending of health care dollars above certain thresholds, it is able to share in the savings generated for Medicare. In 2014, 20 Pioneer and 333 Shared Savings Program ACOs generated more than $411 million in savings, which includes all ACOs savings and losses. The results also show that ACOs with more experience in the program 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.

John Muir Health's Medicare ACO is one of the ACOs, and the only one out of 29 Medicare Shared Savings Program (MSSP) ACOs in California, that is eligible to share in savings. John Muir Health's Medicare ACO also achieved the most shared savings in the state among MSSP ACOs in 2013. Nationally, 11 of the 20 Pioneers and 92 of the 333 MSSP ACOs were eligible to share in savings in 2014.

"Due to exceptional care coordination by our physicians and staff, we were able to generate a savings of more than $8.1 million in our second year of participation in the Shared Savings program. Over the first two years of the program, we've been able to achieve more than $20 million in savings," said Ute Burness, John Muir Health's Medicare ACO Executive. "The savings only tell part of the story as the real benefits are to the overall health of our Medicare patients."

"Our second year results demonstrate that we continue to deliver higher quality care and a superior patient experience, all at a lower cost," said Richard Fraioli, M.D., Medical Director of John Muir Health's Medicare ACO. "We're focused on preventive care and, when care is needed, delivering the right care, at the right time and in the most appropriate setting."

For more detailed quality and financial results, click here.

Additional Resources

Visit the Medicare Shared Savings Program News and Updates webpage to access the HHS press release and fact sheet, the link to the Performance Year 2014 results file, and to learn more about the program.

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