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Trinity Health ACO Delivers $22.4M in Share Shavings, 98% Quality Performance Score

by Fred Pennic 01/16/2020 Leave a Comment

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Next Generation Accountable Care Organization (ACO),

– Trinity Health ACO achieved a nearly 98 percent quality performance score and $22.4 million in shared savings in the performance year 2018. The Next Generation ACO Model was created by the Centers for Medicare & Medicaid Services (CMS) and is in its fourth year.

– Trinity Health ACO provides coordinated care to patients in Illinois (Loyola Medicine), Michigan (Mercy Health – Michigan), New Jersey (Summit Medical Group) and Ohio (Mount Carmel Health System).

Trinity Health ACO, a Next Generation Accountable Care Organization (ACO), announced this week it has achieved $22.4M in share savings reaching a nearly 98 percent quality performance in the performance year 2018. Next Generation ACOs like Trinity Health ACO are patient-centered organizations in which providers have access to better information about their patients’ medical histories and better relationships with their patients’ other providers.

Trinity Health ACO Coverage Areas

Trinity Health ACO provides coordinated care to patients in Illinois (Loyola Medicine), Michigan (Mercy Health – Michigan), New Jersey (Summit Medical Group) and Ohio (Mount Carmel Health System). In 2018, Trinity Health ACO also provided care to patients in New Jersey at Our Lady of Lourdes Health Care Services. Patients experience no change in their original Medicare benefits and retain their freedom to see any Medicare provider. In order to share the savings it achieves for the Medicare initiative, Trinity Health ACO is required to succeed in both delivering high-quality care and spending health care dollars more wisely.

 Next Generation ACO Model Background

Created by the Centers for Medicare & Medicaid Services (CMS), the Next Generation ACO Model is currently in its fourth year. It sets predictable financial targets, give beneficiaries more opportunities to manage their own health, and enables providers to better coordinate care across health systems. In these ways and more, it strives to attain the highest quality standards of care for Medicare recipients.

Impact of Next Generation ACOs

Next Generation ACOs like Trinity Health ACO often also offer expanded benefits, which may include telehealth benefits and/or a waiver of the three-day skilled nursing facility (SNF) rule. This waiver allows eligible patients, whose doctors participate in the Next Generation ACO Model, to be admitted to a SNF directly from their home or a doctor’s office, or from a hospital if they have fewer than three consecutive inpatient days in the hospital.

Participation in Next Generation ACOs is voluntary for providers who — when part of the Model — are payed based on the quality, rather than quantity, of care they provide to patients.

“We are grateful to the providers working to improve the quality of care and patient experience in the Trinity Health ACO for their efforts to make this innovative program a success,” said Emily Brower, senior vice president, clinical integration and physician services, for Trinity Health. “In 2018, Trinity Health ACO achieved a savings nearly three times greater than in the previous performance year, which is an important indicator of how very effective the Model is and of the dedication of our providers’ commitment to providing the best care possible.”

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Tagged With: accountable care, ACO, ACO Model, ACOs, CMS, Health Systems, medicaid, medical group, medicare, Mercy Health, model, Patient Experience, Shared Savings

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