Cleveland, OH,
02
December
2022
|
08:56 AM
America/New_York

MetroHealth Successful Generating Savings in CMS’ Global and Professional Direct Contracting Model

In 2021, The MetroHealth System’s Collaborative Care Partners Accountable Care Organization continued its long track record of achieving savings for the federal government while providing outstanding care to traditional Medicare members.

Building on its accomplishments in the Centers for Medicare and Medicaid Services (CMS) Medicare Shared Savings Program (MSSP), MetroHealth’s ACO achieved $4.8 million in gross savings for CMS in its new Global and Professional Direct Contracting (GPDC) model. From that savings, MetroHealth was awarded more than $3.1 million as a net earned performance payment.

Direct Contracting Entities (DCE) are groups of doctors, hospitals and other health care providers who work 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.

MetroHealth’s Collaborative Care Partners is the only Global and Professional DCE serving Ohio. It is one of only 53 DCEs in the nation and among the 39 that participate in the GPDC Global Track, CMS’ highest track, which is fully capitated and 100% risk-bearing. MetroHealth has participated in CMS’ risk-based models since 2014, each year achieving quality results coupled with cost control below CMS benchmarks.

For the recently completed 2021 DCE performance period of April 1 through Dec. 31, Collaborative Care Partners performed 4 percent better than the CMS-established benchmark. This percentage result indicates the ability of a DCE to effectively manage costs lower than expected while providing quality care to patients. 

MetroHealth’s participation in the DCE served approximately 9,500 Medicare beneficiaries. Over the past six years, MetroHealth has saved the federal government $42.5 million, earning savings totaling $26.8 million. This earned savings equates to the CMS benchmark less the total cost of care and application of CMS’ risk corridors and sequestration amounts.

“The dedicated and unified efforts across The MetroHealth System, as well as its Population Health Innovation Institute, brought extraordinary care to our patients and outstanding population health results to our value-based CMS model,” said Nabil Chehade, MD, Executive Vice President, Chief Population and Digital Health Officer, and Interim CEO of The MetroHealth System.

The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.

About The MetroHealth System

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.