Cleveland, OH,
31
August
2021
|
08:22 AM
America/New_York

MetroHealth Earns Medicare Shared Savings for Five Consecutive Years

The most recent Medicare Shared Savings Program (MSSP) results announced in late August report that MetroHealth Care Partners Accountable Care Organization (ACO) generated significant savings by performing 11 percent better than the 2020 benchmark set by the Centers for Medicare and Medicaid Services (CMS).

This percentage measure indicates an ACO’s ability to control costs while maximizing quality and lends to ACO comparisons. Over the past 5 years, MetroHealth’s ACO achieved cost control averaging over 8 percent per year better than its CMS Benchmarks for 2016 through 2020, respectively.

“We are proud of our clinical team’s dedicated service to patients,” said Dr. Nabil Chehade, MetroHealth Executive Vice President and Chief Clinical Transformation Officer. “The MetroHealth System’s commitment to care delivery excellence and our ACO achieving multi-year Medicare Shared Savings.”

MetroHealth Care Partners ACO saved CMS $9.2 million for 2020, from which MetroHealth will receive a net earned performance payment of $6.7 million. Over the past five years, MetroHealth has earned Medicare Shared Savings totaling $23.7 million, by saving the federal government $37.7 million.

The MetroHealth System is the top-performing academic medical center in Cleveland participating in the MSSP, a notable achievement given the diverse population it serves and the specialties and complexity of care MetroHealth offers. It attained the highest share rate of all Northeast Ohio MSSP ACO participants for this performance year 2020.

In 2019, MetroHealth had the highest share rate of all legacy MSSP ACOs in the Greater Cleveland market. MetroHealth operated the only MSSP ACO in this market to achieve shared savings for 2018 and 2017 as well. Among 513 participating ACOs in 2020, MetroHealth’s cost control performance was in the top 5 percent of ACOs nationwide.

Caring for 8,886 Medicare beneficiaries through its population health focus and care management approaches, MetroHealth’s ACO excelled in CMS’ most advanced value-based risk-bearing MSSP model, called the Enhanced Track (formerly named Track 3), that qualifies for 75 percent risk-sharing for MetroHealth by CMS. Of the 74 Enhanced Track ACOs in the U.S. this past year, MetroHealth’s ACO ranked in the Top 10.

“MetroHealth’s successful track record managing quality and cost reflect the close partnership between our integrated delivery system and our Population Health Innovation Institute. The Medicare program is one of many opportunities benefiting from that close collaboration,” said Susan Mego, MetroHealth Care Partners’ ACO Executive, Collaborative Care Partners President and MetroHealth’s Executive Director of Payer Strategy, Managed Care and Operations.

After its 2020 MSSP ACO performance year completed, MetroHealth then transitioned its MSSP ACO participation in order to advance its ACO provider participants into CMS’ latest value-based model called Global and Professional Direct Contracting (GPDC) at the highest risk-sharing arrangement, 100 percent savings/losses with total care capitation payments. In April 2021, Collaborative Care Partners (CCP) launched as MetroHealth’s Direct Contracting Entity, remains one of the 53 pioneering organizations in CMS’ GPDC Model across the United States and is now expanding.

Medicare ACOs are groups of doctors, hospitals and other health care providers who come together to provide coordinated care to their Medicare patients. The goal is to ensure that patients get the right care at the right time while avoiding unnecessary care, averting duplication of services, and preventing medical errors.

CMS required 23 quality measures, along with financial benchmarks, from MSSP ACOs. MetroHealth’s ACO was awarded a 97 percent quality score by CMS for this 2020 period. Due to the enactment of CMS’ extreme and uncontrollable circumstances policy, MSSP ACOs received the higher of the mean quality score across all ACOs or the ACO's own quality score for performance year 2020. When an ACO achieves savings through improved care coordination and care that is appropriate, safe, and timely while performing to quality targets, the ACO earns a share of the Medicare savings generated for CMS.

About The MetroHealth System

The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.

The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.

Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.

MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.

As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.

Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.

The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.

For more information, visit metrohealth.org.