The Centers for Medicare & Medicaid Services (CMS) recently announced that Advocate Health Care and its Affiliated Medicare Accountable Care Organization (ACO), Advocate Physician Partners Accountable Care, Inc. (APPAC), realized $60.6 million worth of cost savings in 2016.
Ranking second in savings of 432 ACOs participating in the Medicare Shared Savings Program (MSSP), Advocate was among the highest in quality results while providing care to the largest group of Medicare beneficiaries.
“By transforming health care through our innovative approach to population health, we’ve demonstrated for the second year in a row that higher quality and lower cost can go hand in hand,” said Lee B. Sacks, M.D., chief medical officer of Advocate Health Care. “Our expert care providers and administrators have for years worked diligently to build a clinical infrastructure that eliminates unnecessary costs while advancing the overall quality of care. These efforts ultimately work to improve the health of the patients and communities we serve.”
Several initiatives across Advocate’s continuum of care contributed to improved patient outcomes and cost savings. Notable wins included:
- Reduction in congestive heart failure (CHF) hospitalizations due to improved post-discharge follow-up care with CHF clinics across Advocate, as well as outpatient care management.
- Reduction in skilled nursing facility and home health expenditures due to effective and continued partnerships with the Advocate Post-Acute Network and Home Health program.
- Higher quality of care due to increase in primary care services and higher focus on preventive health services and wellness visits.
- Avoidance of hospital readmissions and better outcomes from care coordination efforts.
Since Advocate’s ACO participation in the MSSP commenced in 2012, the health system has reduced the total cost of care for its over 139,000 assigned beneficiaries.
MSSP ACOs are offered financial incentives to both improve quality and reduce health spending. When an ACO – a group of doctors, hospitals and other providers that form networks to coordinate patient care – demonstrates that it has achieved certain quality and cost reduction benchmarks, it is rewarded with a share in the savings generated for Medicare. These savings are re-invested in quality improvement programs that ensure patients get the best care at the best time and in the best setting.