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Two UniNet-managed Medicare Shared Savings Program ACOs Approved for 2016

Jan 22, 2016

Two UniNet-managed Medicare Shared Savings Program ACOs Approved for 2016

Two provider organizations managed by UniNet have been approved as Medicare Shared Savings Program Accountable Care Organizations (ACO) by CMS.

Omaha-based Alegent Health Partners was selected to move from Track 1 (shared savings only) to Track 3, a new level that involves shared savings and risk. Newly formed TPN Health Partners in Lincoln, Kearney, and Grand Island was approved to start at the Track 1, or shared savings only level.

Shared Savings Program ACOs are groups of doctors and other health care providers who voluntarily work together with Medicare to give high-quality service to Medicare beneficiaries. With the new and renewing ACOs announced by CMS on January 11, there now are 434 total Shared Savings Program ACOs serving more than 7.7 million beneficiaries.

Congress created the Shared Savings Program to facilitate coordination and cooperation among providers to improve the quality of care for Medicare beneficiaries and reduce unnecessary costs. ACO providers are collectively responsible for the cost and quality of care a particular set of patients receive in a calendar year. If ACO members meet agreed upon savings and quality metrics, the ACO can earn bonuses and share in a percentage of savings they generate for Medicare.

Alegent Health Partners

Alegent Health Partners (AHP) was approved by CMS in 2013 and includes CHI Health employed providers and independent providers in the Omaha metro area. Alegent Health Partners was selected as one of nearly 150 renewing Medicare Shared Savings Program ACOs providing Medicare beneficiaries with access to high-quality, coordinated care across the United States.

AHP was selected to move from Track 1 to Track 3, which is a new risk arrangement with CMS that provides an opportunity for greater shared savings (up to 75 percent) if the ACO meets quality in a manner that costs less than the projected benchmark, but also shared financial risk if spending exceeds the benchmark.  

From 2013 to 2015, Alegent Health Partners providers worked together and closely monitored outcomes and costs for nearly 28,000 area Medicare beneficiaries. While the Alegent Health Partners ACO has not yet earned a performance bonus, in 2014 it saved more than $1 million, achieved a quality score of 87.76 percent, and completely reported on 100 percent of the quality measures. In Alegent Health Partners’ second year of managing the ACO they improved by 2.2 percent. 2015 results have not yet been released. Areas of opportunity in 2016 include long-term acute care and skilled nursing admissions, COPD admissions, HF admissions, vaccinations, BMI and follow-up, and cancer screening.

TPN Health Partners

TPN Health Partners is a new MSSP ACO that includes TPN employed providers in the Lincoln, Kearney, and Grand Island areas. They are one of 100 new Medicare Shared Savings Program ACOs. TPN Health Partners was approved to participate in the Medicare Shared Savings Program at the Track 1 level. If TPN Health Partners meets defined savings and quality benchmarks, the ACO can share in the savings it generates but is not responsible for any losses.

More information will be sent to providers participating in both ACOs regarding performance metrics and results reporting.

More information about the Shared Savings Program is available at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/sharedsavingsprogram/index.html?redirect=/sharedsavingsprogram/.

 



Tags: ACO
Category: News Article