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.
Founded in 1837, MetroHealth is leading the way to a healthier you and a healthier community through service, teaching, discovery, and teamwork. Cuyahoga County’s public, safety-net hospital system, MetroHealth meets people where they are, providing care through four hospitals, four emergency departments, and more than 20 health centers and 40 additional sites. Each day, our 8,000 employees focus on providing our community with equitable health care–through patient-focused research, access to care, and support services–that seeks to eradicate health disparities rooted in systematic barriers. For more information, visit metrohealth.org.