John Muir Health Medicare ACO: Shared Savings Program 2015 Quality & Financial Results

September 8, 2016  The Centers for Medicare & Medicaid Services (CMS) recently 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 continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.

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

The John Muir Health Medicare ACO is one of the ACOs that is eligible to share in savings, and, in fact, as compared to other Medicare Shared Savings Program (MSSP) ACOs in California, achieved the highest amount of savings -- $6,987,155. Nationally, 119 of the 392 MSSP ACOs were eligible to share in savings in 2015. Of the MSSP ACOs operating solely in California, John Muir Health also had the highest quality score – 96.5%. The quality score is based on 33 quality measures ranging from depression screening to medication reconciliation.

"Due to exceptional care coordination by our physicians, nurses and staff, we were able to generate a savings of more than $27 million in our three years of participation in the Shared Savings program," said Ute Burness, John Muir Health's Medicare ACO Executive. "The much larger benefit has been to the overall health and experience of our Medicare patients."

"Our results demonstrate that we continue to focus on and deliver on the triple aim – improving the quality of care and patient satisfaction, improving the overall health of populations and reducing the cost of care," said Richard Fraioli, M.D., Medical Director of John Muir Health's Medicare ACO. "We’ve learned a great deal from our participation in the Medicare Shared Savings Program ACO. We will apply these learnings to our ongoing care coordination and population health management initiatives to support our patients and clinicians." 

Additional Resources

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.

About John Muir Health

John Muir Health is a nationally recognized, not-for-profit health care organization east of San Francisco serving patients in Contra Costa, eastern Alameda and southern Solano Counties. It includes a network of more than 1,000 primary care and specialty physicians, more than 6,000 employees, medical centers in Concord and Walnut Creek, including Contra Costa County’s only trauma center, and a Behavioral Health Center. John Muir Health also has partnerships with UCSF Health, Tenet Healthcare/San Ramon Regional Medical Center and Stanford Children's Health. The health system offers a full-range of medical services, including primary care, outpatient and imaging services, and is widely recognized as a leader in many specialties – neurosciences, orthopedic, cancer, cardiovascular, trauma, emergency, pediatrics and high-risk obstetrics care.

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