MetroHealth Innovation Leads to CMS Direct Contracting Entity
Cleveland - The MetroHealth System is implementing a new initiative for Medicare patients that recognizes MetroHealth’s experience in providing high-quality, cost-effective care.
The Centers for Medicare and Medicaid (CMS) recently awarded MetroHealth approval to operate a Direct Contracting Entity, a cutting-edge value-based care model. Implementation is underway now and full operations start April 1, 2021, as Collaborative Care Partners, in which all MetroHealth providers participate.
A CMS Direct Contracting Entity (DCE) is a group of physicians, hospitals and other providers along the health care continuum working together to deliver high-quality coordinated care while helping slow the growth of health care costs. For example, providers work as a team to use information, communications and care settings in more sophisticated ways to assess and address factors that affect patients’ overall health as well as improve wellness activities. MetroHealth applies its innovative care delivery approaches to serve patients who have Medicare fee-for-service coverage as part of its Direct Contracting Entity participation.
“The MetroHealth System is building upon its Medicare Shared Savings Program Accountable Care Organization successes 2014 through current. We are proud to implement the latest evolution of value-based care models both from CMS and with our managed care payers,” said Susan Mego, Collaborative Care Partners President and MetroHealth’s Executive Director of Payer Strategy, Managed Care and Operations.
MetroHealth operates numerous value-based initiatives designed to meet four goals; producing better care for individuals; better health for populations; lower total cost of care, and better care team well-being.
Collaborative Care Partners is another of those initiatives and the type for which the health system utilizes the most advanced risk-bearing payment method.
“This is an exciting occasion giving MetroHealth an even better opportunity to be rewarded when it improves health care while reducing Medicare spending. It directly aligns with how our clinical teams work hand in hand with our Population Health Innovation Institute,” said Dr. Nabil Chehade, Chair of the Collaborative Care Partners Governing Board and MetroHealth’s Executive Vice President and Chief Clinical Transformation Officer.
The MetroHealth System, Cuyahoga County’s public health system, is honoring its commitment to create a healthier community by building a new hospital on its main campus in Cleveland. The building and the 25 acres of green space around it are catalyzing the revitalization of MetroHealth’s West Side neighborhood.
MetroHealth broke ground on its new hospital in 2019. The project is being financed with nearly $1 billion the system borrowed on its own credit after dramatically improving its finances. In the past five years, MetroHealth’s operating revenue has increased by 40% and its number of employees by 21%. Today, its staff of 8,000 provides care at MetroHealth’s four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. In the past year, MetroHealth has served 300,000 patients at more than 1.4 million visits in its hospitals and health centers, 75% of whom are uninsured or covered by Medicare or Medicaid.
The health system 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 teaching and research. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses a Cleveland Metropolitan School District high school of science and health.
For more information, visit metrohealth.org.