Becker's Hospital Review

CARE DELIVERY 81 The Latest ACO Results: 5 Leaders React By Emily Rappleye W e checked in with five leaders of ACOs — two Pio- neers, one Medicare Shared Savings Program and one organization that manages 25 MSSP ACOs, all of which shared in savings or had some ACOs share in savings for 2014. Here, they discuss how their organizations fared and their take on the progress of Medicare ACOs. Participants include: • Emily Brower, vice president of population health at Atrius Health (Newton, Mass.). • Lisa Stevens Anderson, CEO of Banner Health Network (Mesa, Ariz.) and Shaun Anand, MD, CMO of Banner Health Network. • Katherine Schneider, MD, president and CEO of Delaware Valley ACO (Villanova, Pa.). • Jeffrey Spight, president of Collaborative Health Systems (White Plains, N.Y.). Question: Does anything surprise you about the 2014 Medicare ACO results? Emily Brower: We were delighted to see that the results continue to show overall savings for Medicare under value-based payment models. Value-based payment — holding the delivery system accountable for cost, quality and patient experience — is a model we have supported at Atrius Health for many years. Moving to value-based payment is important for the sustain- ability of our healthcare system and delivering the right care to patients and communities. Lisa Stevens Anderson and Dr. Shaun Anand: We were pleased by the across-the-board improvements in clini- cal measures by all the participating ACOs, but not surprised. Banner Health Network remains focused on belief that account- able care is a key opportunity to address spiraling costs, while improving quality and the patient experience. Dr. Katherine Schneider: is is the first year for DVA- CO's participation, so the process is new to us. e nature of the methodology does mean that you don't really know where you stand until the final adjustments are done, and while we knew we had trended in the right direction we were somewhat "on the fence" until the final release. us, we are very pleased to see how well we did. Jeffrey Spight: ere is certainly a lot of information to digest. e 2014 results do show that there are challenges in the existing MSSP structure, and it is disappointing that more ACOs will not be rewarded for delivering higher quality, more efficient care. We do believe the new rule changes that CMS will imple- ment in 2016 will improve the business model for ACOs. We will continue to work with CMS and our ACO colleagues to make further improvements to create a long-term sustainable business model. Q: How did your organization fare in terms of quality and savings in 2014? EB: Atrius Health had among the highest performance on the quality measures again this year — highest among Pioneer ACOs in New England and third highest nationally. ese quality measures include care outcomes and patient experience, which is particularly important to us. We saved $4.5 million for Medicare in 2014, earning shared savings of $2.8 million for Atrius Health. We have a track record of being a lower cost provider for Medi- care in our market, so we are especially pleased to have earned savings beyond our relatively low baseline expenditure. LSA & SA: Banner Health Network delivered its best-ever result in a third successful year as part of the Pioneer ACO. We returned more than $29 million in savings over the predicted financial benchmark (5 percent), while at the same time improv- ing our quality score by nearly 10 percent (quality score of 88). We believe this was possible as a result of engaged, high-per- forming provider partners, enabling technology and a variety of supportive clinical programs. We continue to identify opportuni- ties for continuous advancement, including the further devel- opment of our technology infrastructure and maximizing each touch point along the care continuum. KS: Our organization, partnering physicians and health systems fared well, with savings of $6.5 million, which means we are in the top 10 organizations [in terms] of shared savings earned. ese early results speak to the challenging transformational work that has been taking place in our hospitals and physician practices — all with a focus on delivering superior care at a sustainable cost for our regional economy and the communities we serve. JS: Generally, we were pleased with how the ACOs in our network fared. Nine of our ACOs earned a shared savings pay- ment in 2014, and an additional eight generated savings, but not enough to exceed the minimum savings rate. We were happy to see that in addition to the three ACOs that earned shared savings in the 2012/13 program years, including our flagship ACO in Houston, we saw tremendous progress across the portfolio in 2014, and in particular, for our ACOs in Maryland as well as our ACOs that operate Federally Qualified Health Centers. Add to that, all of our ACOs improved their quality score perfor-

• Cover