With nearly 1,000 commercial, Medicare and Medicaid accountable care organizations (ACOs) covering 32 million members nationwide, value-based contracts continue to grow at a steady rate while the Centers for Medicare & Medicaid Services (CMS) continues to develop additional risk-based program options.
While increasing in popularity, ACO results have been mixed. For example, of the 432 Medicare Shared Savings Program (MSSP) ACOs, only 31 percent earned shared savings in payment year (PY) 2016, according to CMS.1 Organizations looking to better manage their populations and accept more financial risk can benefit from learning from ACOs that have been successful in increasing patient quality and lowering costs.
Tenet Healthcare, a Dallas-based health system, is recognized as a national leader in care innovation, operating ACOs that cover nearly 1 million patients in 80 percent of its markets. Its ACOs participate in more than 85 CMS innovation programs and contract with the largest national payers. Tenet’s Medicare ACOs reported more than $135 million in shared savings from 2012-16.
But organizations that rely exclusively on hard numbers to measure ACO success don’t see the complete picture. Rick Watson, Tenet’s Senior Director of Managed Care Finance and ACO Analytics, knows the winning formula is about more than savings.
“We have a huge focus on quality, which comes from our deep involvement with Medicare,” Watson said. “Our focus on three key areas builds the foundation on which Tenet enhances the quality of care for our members, and in turn, improves our ACOs’ chances of success.”
Position Your ACO for Optimal Success
- Improve quality, efficiency and coordination of care
- Increase collaboration and common quality goals among physicians and hospitals
- Establish innovative relationships with payers, employers and patients
In the following Q&A, Watson elaborates on Tenet’s successes and discusses its proven strategies for delivering on these objectives within its ACO networks.
Need help developing or managing your risk-based contracts? Here’s how Conifer Health helps organizations succeed under new payment models.