Tags: affordability

By Timothy Ferris, MD, MPH, Partners Senior Vice President for Population Health

According to federal data released today, Partners HealthCare has successfully improved the quality of care provided to approximately 84,000 Medicare patients.  As a Pioneer Accountable Care Organization (ACO), we were selected by the Center for Medicare & Medicaid Innovation (CMS Innovation Center) in 2012 to participate in a five year initiative to test the effectiveness of a new model of payment.  We are currently one of nine remaining participating organizations across the country. 

The Pioneer payment model aims to transform the way that health care is delivered by providing Medicare patients with higher quality care, while slowing cost growth through enhanced care coordination. The federal government provides incentives for participating doctors and hospitals using a “shared savings” approach. ACOs are rewarded with a portion of their savings if the total health care spending is below the level that Medicare expected. Quality measures are used to ensure that organizations are improving health outcomes as they seek to reduce growth in Medicare expenses.

Over the past four years, our efforts at Partners have reduced costs of care for Medicare by a total of $31.5 million.

Over the past four years, our efforts at Partners has reduced costs of care for Medicare by a total of $31.5 million (Partners was awarded $20.4 million and the federal government retained $11.1 million). In the fourth year of participation, we did not generate savings, narrowly missing cost containment goals by 0.8%.  However, the federal government did highlight several improvements in specific categories.

For patients with disabilities and patients with end stage renal disease, our growth in expenses was lower than our ACO benchmark (a reduction of 1.6 and 1.3 percentage points respectively). We attribute the reduction in expenses to our high risk care management program, which assigns nurse care managers to care for chronically ill patients with multiple medical conditions, and is helping to lower costs and improve care.  Currently, we are managing the care of over 10,000 high risk Medicare patients.

We also trended better than the benchmark in outpatient and skilled nursing facility expenditures.  The growth in nursing facility expenditures was 1.1 percentage points lower than the growth in the national Medicare population, which suggests our programs are making a difference in reducing costs and providing more efficient care.  Hospice use among the Partners network also increased, indicating more of our patients are benefitting from this important service.

As in previous years, we continue to deliver high quality care to Medicare patients. We scored well in virtually all quality indicators that the federal government tracks as part of the Pioneer ACO initiative. With an overall quality score of 96.04%, Partners is among the best ACOs in the nation for delivering high-quality care to patients. We scored exceptionally in two of the four measurement domains receiving a 100% quality score in preventative health screening and managing at-risk populations. 

Our efforts in population health management have been the main driving force in achieving these results. These year-four results contain some continued encouragement, but we are also reminded of the numerous challenges of sustained containment of cost growth year after year.  We will continue to sharpen our focus on efforts to achieve our goals of both improving quality and reducing the growth of health care costs.