ASHEVILLE, N.C. (October 16, 2017) – The Centers for Medicare & Medicaid Services (CMS) released its 2016 Quality and Financial Performance Results, showing that Medicare Accountable Care Organizations (ACOs) continue to improve the quality of healthcare for Medicare beneficiaries while also decreasing costs for consumers and taxpayers. Of note, the data also show that our local ACO – Mission Health Partners (MHP) – performed among the very best in the nation, achieving a Quality Score of over 97% and saving Medicare over $11 million beyond its target, despite having one of the lowest spending benchmarks in the nation.
Brian Moore, MD, North Buncombe Family Medicine a Mission Health Partners cofounder and Board Chair said, “I am very happy about the success Mission Health Partners has had in achieving extraordinary quality performance and shared savings in just our second year of participation in the Medicare Shared Savings Program. The leadership of our Executive Director, Ms. Amanda Gerlach and of our Medical Director, Dr. Rob Fields has been superb. I know that the courage and vision they showed in implementing a novel social determinants model of care coordination to address the needs of the whole patient is a key to our early success. It was the critical ingredient we needed to add to the great work our network of physicians has already been doing, to push us over the edge. ”
Ronald A. Paulus, MD, President and CEO of Mission Health and a MHP Board Member, noted that “The definition of value in healthcare is embodied by Mission’s BIG(GER) Aim: to get each person to their desired outcome, first without harm, also without waste and always with an exceptional experience for every patient, family and team member. Today’s CMS release reconfirms that patients in western North Carolina are receiving some of the highest value care in the nation. As members of MHP, we are proud to deliver that care at every Mission Health hospital, and every Mission Health clinic, to every patient, every single day, whether they are covered by Medicare or not.”
Across the country, there are 480 Shared Savings Program Accountable Care Organizations serving nine million Medicare beneficiaries. ACOs allow doctors, hospitals, and other healthcare providers to better coordinate care for Medicare patients. Participation in an ACO creates incentives for healthcare providers to work together to treat an individual patient across all care settings—including doctor’s offices, hospitals, and long-term care facilities.
To achieve a gain share payment, an ACO must first beat its individual spending target. If it does so by a sufficient amount, it is entitled to a gain share payment, but only if it also achieves defined quality targets. Quality is assessed based upon thirty-four individual measures of quality performance spanning four quality domains: Patient Experience of Care, Care Coordination/Patient Safety, Preventive Health, and At-Risk Population.
Mission Health Partners (MHP), a Clinically Integrated Network and Medicare ACO that currently serves approximately 90,000 patients, includes nearly 1,100 physicians spanning the 18 counties of western North Carolina who are committed to building a network focused on improving the health of our population. In addition to achieving cost savings, MHP takes a unique care coordination approach by taking into account the social and environmental factors that influence a patient’s health outcomes. By also connecting its patients with resources and community partners like MANNA food bank and Pisgah Legal Services, MHP helps its patients meet their most critical basic needs, clearing the pathway for them to focus on their health. It’s an approach the MHP hopes to develop as a model for use across the country.
About Mission Health Partners
Mission Health Partners (MHP) is a patient-centric and physician-governed network of clinicians, hospitals and other healthcare providers, working collaboratively in an evidence-based manner to improve patient care and experience, decrease cost and ultimately drive positive changes in the health of the residents of western North Carolina. MHP is among one of the largest ACOs in the country, covering 58,000 Medicare beneficiaries. MHP also covers 18,000 lives through the Mission Health employee benefits plan and some 8,500 patients attributed through Humana Medicare Advantage. In 2017, MHP has added 4,700 United Medicare Advantage members and 1,500 Healthy State beneficiaries, through both its Medicare Advantage and direct to employer offerings. We are currently accountable for the cost and quality of care for more than 10 percent of western North Carolina. For more information, please visit missionhealthpartners.org.
ABOUT MISSION HEALTH
Mission Health, based in Asheville, North Carolina, is the state’s sixth-largest health system. For the fifth time in the past six years, Mission Health has been named one of the nation’s Top 15 Health Systems by Truven Health Analytics, an IBM Company and part of IBM Watson Health in 2017. We are the only health system in North Carolina to achieve this recognition. Mission Health operates six hospitals, numerous outpatient and surgery centers, post-acute care provider CarePartners, long-term acute care provider Asheville Specialty Hospital, and the region’s only dedicated Level II trauma center. With approximately 12,000 team members and 2,000 volunteers, Mission Health is dedicated to improving the health and wellness of the people of western North Carolina. For more information, please visit mission-health.org or @MissionHealthNC.