Network improved quality of care, lowered cost; a leading model for accountable care organizations.
The Centers for Medicare & Medicaid Services (CMS) today announced its Financial Reconciliation Report, Performance Year 2016 results for the Medicare Shared Savings Program which identified LHS Health Network, a member of Trinity Health, had reduced healthcare expenditures by $8.4 million last year.
The report looks at data from 2016. It shows LHS Health Network’s Accountable Care Organization (ACO) had a total expenditure of about $53 million. This was against a benchmark figure of $61.5 million.
“Our provider network has worked diligently to improve patient care through initiatives that have resulted in fewer inpatient admissions, emergency room visits and skilled nursing facility utilization,” commented Jennifer Schwartz, president of LHS Health Network. “We are excited to have achieved our goal while ensuring that patients get the right care from the right provider at the right time.”
By meeting quality performance standards and exceeding its minimum savings threshold, LHS Health Network qualified for shared savings payments. LHS Health Network will receive a payment of over $3.5 million, which will split between the ACO and its physician members. Overall, the Network achieved a 13.67% reduction in healthcare costs. This was based on a relatively modest number of covered lives (5,469 beneficiaries).
“We are extremely proud that LHS Health Network has garnered such positive results” said Reginald Blaber, MD, MBA, president of Lourdes Health System. “Their work proves that hospitals and independent physicians can work together to achieve the three-part aim of better quality, better access to care and lower costs.”
LHS has participated in the Medicare Shared Savings Program with CMS for the past three years. The SharedSavings Program is an alternative payment model that promotes accountability for a patient population, coordinates items and services for Medicare beneficiaries, and encourages investment in high quality and efficient services.
Since the passage of the Affordable Care Act, more than 470 Medicare Accountable Care Organizations, serving nearly 8.9 million Medicare beneficiaries, have been established. ACOs are judged on performance, as well as improvement, on an array of metrics that assess the delivery of care. Those metrics include how highly patients rated their doctor, how well clinicians communicated, whether patients are screened for high blood pressure, and their use of Electronic Health Records.
In addition to the Medicare beneficiaries, LHS Health Network covers over 50,000 patients in commercial health management organizations such as Horizon, Aetna and AmeriHealth.