ARTICLE
Atlantic Health System’s four accountable care organizations saved Medicare a total of more than $21 million through efforts to improve quality and reduce health care costs in 2019, according to recently released performance data from Centers for Medicare & Medicaid Services (CMS). The four ACOs - Atlantic ACO, HealthCare Quality Partners ACO, Care Better ACO and Optimus Healthcare Partners ACO – improved care for 75,000 Medicare beneficiaries in northern and central NJ and registered the savings by meeting quality and cost goals ranging from preventive health checks to use of computerized health records to preventing avoidable hospitalizations. A market-based solution to fragmented and costly care, accountable care organizations empower local physicians, hospitals and other providers to work together and take responsibility for improving quality, enhancing patient experience and keeping care affordable. The Medicare Shared Savings Program (MSSP) creates incentives for ACOs to invest in transforming care by allowing them to share in savings they generate after meeting defined quality and cost goals. The $21,406,076 of savings to Medicare resulted in $7,846,759 in shared savings payments that were passed on to providers in three of the ACOs. Optimus Healthcare Partners has saved Medicare dollars in every year since 2012 and received a shared savings in six of the seven years, including 2019. Care Better ACO, which was created in 2019, registered savings for Medicare despite not achieving shared savings for providers. “When providers work together through an ACO to focus on patients and invest in care coordination, information technology and other care improvements, they can both increase quality and reduce costs,” said Thomas H. Kloos MD, executive director of the Atlantic Management Services Organization, which manages the ACOs, and chair of the board of directors for the National Association of ACOs (NAACOS). “ACOs like ours are measurably improving care and saving money while maintaining patients’ choice of Medicare providers.” At Atlantic Health System, ACO providers work to increase the number of Medicare beneficiaries taking advantage of annual wellness visits, including recommended screenings and preventive care. The ACOs also focus on ensuring smooth patient transitions from the hospital to home—or a nursing home if needed. All ACO providers receive detailed information about their performance on quality measures, and clinicians and providers share best practices to coordinate the care beneficiaries receive from different primary care and specialty providers and to prevent health issues and repeat hospitalizations. “These results demonstrate the continued value of coordinated care – providers work more easily together, care gets better and costs get lower,” said Brian Gragnolati, president and CEO of Atlantic Health System. “Our accountable care organizations continue to make the experience of delivering care a more positive one for all involved.” In 2019 nationally, 541 ACOs caring for 11.2 million beneficiaries participated in the MSSP, generating gross savings of $2.6 billion based on the CMS methodology for setting financial benchmarks. After accounting for shared savings earned by ACOs in 2019, estimated net Medicare savings were $1.2 billion.