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 $11.4 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 eight consecutive years, and one of only 13 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.
“For our ACO to earn more shared savings than ever before in such a challenging year is an amazing testament to our providers’ commitment to their patients” said Matthew Siegler, CEO of the ACO and NYC Health + Hospitals Senior Vice President for Managed Care at NYC Health + Hospitals. “This success is also yet another sign that NYC Health + Hospitals is a national leader in advancing value-based care and that safety net health systems can lead the way in improving quality and advancing health equity.”
These results mark the eighth 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 9,000 Medicare fee-for-service patients who are served through the program.
For 2020, the ACO reduced costs for its Medicare patients by $15.7 million, of which it earned $11.4 million in shared savings (this compares to $4.62 million in 2019). The ACO also received a 96.8 percent overall quality performance score.
“There are two things we always do for our patients that further support our ongoing positive ACO outcomes. One is to ensure they receive all the preventive screenings and vaccinations that keep them healthy. And the other is to give focused attention to patients with chronic illnesses, which allows them to avoid preventable complications. Taken together, our patients can live their healthiest life possible,” said Chief Medical Officer for Ambulatory Care Services at NYC Health + Hospitals/Elmhurst Rand A. David, MD.
“For eight years in a row, patients are healthier and providers are happier because of the benefits of our Accountable Care Organization,” said Chief of Medicine at NYC health + Hospitals/Gotham Health Sydenham Jean-Marie H. Claude, MD. “These are valuable earnings that then we’re able to recontribute back into the exceptional healthcare we provide all patients.”
Since the ACOs inception in 2013, it has saved the Medicare program over $67.3 million, resulting in earned shared savings and subsequent investment of approximately $35.1 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.
NYC Health + Hospitals is the largest public health care system in the nation serving more than a million New Yorkers annually in more than 70 patient care locations across the city’s five boroughs. A robust network of outpatient, neighborhood-based primary and specialty care centers anchors care coordination with the system’s trauma centers, nursing homes, post-acute care centers, home care agency, and MetroPlus health plan—all supported by 11 essential hospitals. Its diverse workforce of more than 42,000 employees is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible. For more information, visit www.nychealthandhospitals.org and stay connected on Facebook at https://www.facebook.com/NYCHealthSystem or Twitter at @NYCHealthSystem.