Becker's Hospital Review

18 CFO / FINANCE 10 ACOs with the most shared savings in 2019 By Morgan Haefner M edicare Shared Savings Program ACOs generated a record $1.2 billion in net savings for the Medicare program across 541 ACOs in 2019, CMS Administrator Seema Verma announced Sept. 14 in Health Af- fairs. e 2019 data includes the first six months of performance for ACOs that participated in the agency's new Pathways to Success program, an MSSP overhaul that began in July 2019. ACOs in the Pathways to Success program performed better than legacy ACOs, seeing net per-benefi- ciary savings of $169 compared to $106 for legacy ACOs, according to Ms. Verma. Currently, more than 11.2 million fee-for-service Medicare beneficiaries are served by providers in ACOs, and see lower post-acute spending, hospi- talizations and emergency department visits. Here are the top 10 ACOs for total earned shared savings in 2019. e total is the addition of earned shared savings presented in two datasets: one for ACOs that started in the new program in July 2019, and another for ACOs with a program start date of Jan. 1, 2019. 1. Palm Beach Accountable Care Organization (Palm Springs, Fla.) — $48.7 million 2. Millennium Accountable Care Organization (Fort Myers, Fla.) — $41.9 million 3. Baylor Scott & White Quality Alliance (Dallas) — $34.3 million 4. Federation ACO (Portage, Mich.) — $33.5 million 5. Central Oregon ACO, doing business as Caravan Collaborative ACO 17 (Bend) — $32.9 million 6. Mercy Health ACO (St. Louis) — $24.2 million 7. Silver State ACO (Las Vegas) — $23.4 million 8. Advocate Physician Partners Accountable Care (Rolling Meadows, Ill.) — $22.7 million 9. Accountable Care Organization of Aurora/ Aurora Accountable Care Organization (Milwau- kee) — $19.5 million 10. LTC ACO (Kennett Square, Pa.) — $18.8 million n Pennsylvania health system merger could hike costs 20%, economist says By Ayla Ellison T he estimated $599 million merger of Jefferson Health and Einstein Health Network would push hospital costs higher, an economist commissioned by the Federal Trade Commission testified Sept. 15, according to Law360. The FTC announced in February that it would sue to block the merger of the two Philadelphia-based health systems, arguing it would reduce competition in Philadelphia and Montgomery counties. The FTC's injunction hearing began Sept. 14. Loren Smith, PhD, a princi- pal with the Brattle Group's global antitrust and competition group, tes- tified during the second day of the hearing that the merger would likely have anti-competitive effects in both Philadelphia County and Montgom- ery County, according to the report. Dr. Smith, an economist who testified as an expert for the FTC, said the merger of Jefferson Health and Einstein Health Network could boost some acute care hospital costs by 9 percent and inpatient rehabilitation costs by as much as 20 percent, according to Law360. The two health systems argue that Einstein Health Network will remain on shaky financial footing without the merger and that the combination is needed to save Einstein's flagship hospital. n CMS threatens to terminate Chicago hospital's Medicare contract By Ayla Ellison C hicago-based Holy Cross Hospital is at risk of losing its Medicare bill- ing privileges due to patient safety issues, according to an Aug. 25 let- ter from CMS to the hospital obtained by Chicago NPR station WBEZ. CMS sent the letter after inspectors visited the hospital and discovered staff had failed to identify and remove "ligature risks" in its adult behav- ioral health unit, according to the CMS inspection report cited by WBEZ. Ligature risks include hinges, door frames or anything that patients could use to strangle or hang themselves, according to the report. Inspectors found two bathroom doors in the hospital's behavioral health unit with protruding hinges and eight patient beds with steel rings at- tached that could be used to fasten restraints. The executive director of the behavioral health unit told inspectors, "It is not safe to have patients in these identified ligature risk rooms," according to the report. In the letter to the hospital's chief administrator, CMS said the deficiencies identified during the inspection "are so serious that they constitute an immediate threat to patient health and safety." Hospital leaders are taking steps to resolve the deficiencies and keep the hospital's Medicare contract, a spokesperson told WBEZ. "Our leadership team is taking this matter seriously and is pulling togeth- er an improvement plan to immediately course correct the identified ar- eas of improvement," the spokesperson wrote in an emailed statement to WBEZ. "We want to be clear in stating that Holy Cross is not closing." n

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