Oct 09, 2019
NYC Health + Hospitals today announced that its Accountable Care Organization (ACO) – a group of doctors and other providers who coordinate care for patients under the Medicare Shared Savings Program (MSSP) – will earn nearly $3 million from the federal government for reducing costs and meeting high standards of quality care for patients. The health system’s ACO is the only MSSP ACO based in New York State to earn shared savings for six consecutive years and one of only 18 ACOs around the country to have earned that distinction. The federal MSSP was created to change the payment structure for the Medicare fee-for-service beneficiary population. It holds participants accountable for the cost and quality of care delivered to a defined patient population over time. There are over 500 ACOs in the MSSP serving over 10.5 million beneficiaries across the country.
“NYC Health + Hospitals has consistently demonstrated that its ACO can provide better care for patients while lowering the growth of health care costs,” said Dave Chokshi, MD, CEO of the ACO and NYC Health + Hospitals Chief Population Health Officer. “We achieved these goals through the hard work of our physicians, nurses, and all the frontline staff who care for our patients. This is truly a shared success.”
“NYC Health + Hospitals’ ACO is a great example of what health care providers can do through the ACO model. It can mean better care coordination for patients and savings for the health care system,” said Assembly Health Committee Chair Richard N. Gottfried. “I congratulate NYC Health + Hospitals on this result, and hope it can be a model for other health care providers across the state.”
NYC Health + Hospitals’ results mark the sixth consecutive year that the public health system’s ACO has achieved savings and outstanding quality performance by improving care coordination in the primary care setting and preventing unnecessary emergency department visits, avoidable hospitalizations, and other high-cost care for the more than 10,000 Medicare fee-for-service patients who are served through the program.
For 2018, the ACO reduced costs for its Medicare patients by $7.26 million, of which the public health system earned $2.97 million in shared savings (compared to $2.18 million in 2017). The ACO also received an 83.4 percent overall quality performance score. The ACO scored highest in the Preventive Health area where it outperformed a majority of ACOs. This area encompasses screening patients for depression, helping patients quit smoking, and proper use of aspirin for patients with heart disease.
Since 2013, the ACO has saved the Medicare program over $43 million, resulting in earned shared savings of over $19 million for NYC Health + Hospitals and its community partners.
The MSSP was created to change the payment structure for the Medicare fee-for-service beneficiary population towards value-based care by holding participants accountable for the cost and quality of care delivered to a defined patient population. Moving forward the ACO is now one of 72 in the nation participating in MSSP’s “Enhanced Track”, an upside and downside risk contract.