Nebraska Health Network Improves Quality and Saves Medicare More than $13 Million
Local Accountable Care Organization Leads Transformation to Value-Based Care
(Omaha, Neb., 10/01/2020): Nebraska Health Network, the accountable care organization for Methodist Health System and Nebraska Medicine, strengthened care for more than 35,700 Medicare beneficiaries and saved Medicare more than $13 million in 2019, according to recently released performance data from the Centers for Medicare & Medicaid Services.
The Medicare Shared Savings Program is an advanced payment model created by CMS to help achieve more favorable health outcomes for individuals, improve population health and lower growth in Medicare expenditures. NHN joined MSSP in 2017 and completed its first, three-year track last year. Collectively, MSSP participants saved Medicare more than $2.6 billion in 2019.
NHN Chief Executive Officer Lee J. Handke, PharmD, MBA, said the Medicare ACO shared savings program is the largest value-based payment model in the country. “Participation in programs like these are critical drivers in the transformation from volume-based care to value-based care where the needs of the patient are put first, and we work together to impact patient care and lower health-care costs.”
Value-based models incentivize ACOs by allowing them to share in savings they generate after meeting defined quality and cost goals. Participants are guided by a set of performance and cost measures ranging from increasing preventive health checks to lowering avoidable hospital admissions. More advanced programs also feature shared-risk agreements that incur financial penalties if measures are not achieved. NHN entered a shared-risk track in January 2020.
ACOs, like the NHN, are groups of doctors, hospitals and health-care providers who work together to provide patients with better, more coordinated care. “We use data and predictive analytics to empower providers by identifying which patients are overdue to be seen, who is most likely to require advanced care or who is at the highest risk of hospitalization,” Dr. Handke said. “Together with our partners at Methodist, Nebraska Medicine and community clinics; we create proactive, accessible and affordable health-care experiences.”
The $13.1 millions of gross savings to Medicare NHN generated in 2019 resulted in a shared savings payment of $6.1 million, which will be reinvested into supporting efforts by the health systems and community clinic partners to assist with value-based care initiatives.
Value-based models help ACOs identify health trends that will have the greatest impact across the entire patient population. The NHN is focused on three key initiatives: increasing Medicare Annual Wellness Visits, improving care coordination and managing post-acute care; all of which support improved health outcomes for Medicare beneficiaries.
Additional information regarding Accountable Care Organizations is available here. Resources include a one-page ACO overview and a five-minute, patient-focused video detailing how ACOs strengthen patient care.