TAMPA, Fla., Oct. 14, 2019 /PRNewswire/ -- WellCare Health Plans, Inc. (NYSE: WCG) and Collaborative Health Systems (CHS), a WellCare company, announced today that 13 CHS Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) – nearly 90% of all CHS ACOs – delivered $53.3 million in total savings to Medicare for performance year 2018, according to figures released by the Centers for Medicare & Medicaid Services.
Earning Shared Savings and Meeting Quality Standards
This marks the sixth performance year CHS, one of the largest Medicare ACO sponsors in the country, generated savings for Medicare, earned shared savings for ACOs and met MSSP quality standards.
In performance year 2018, 15 CHS ACOs served 129,000 Medicare beneficiaries and achieved a total quality score of 90%. Overall, eight CHS ACOs (53%) generated $22.8 million in shared savings in performance year 2018 – nearly double that of performance year 2017 – and 1.5 times greater than the MSSP program average of 37%.
Generating Long-Term Savings for Medicare
In total, CHS ACOs active during performance years 2015 – 2018 generated more than $298 million in total net savings to the Medicare Trust Fund since 2012, the first year of the program, and $165.3 million in shared savings.
"We are incredibly proud of our 2018 performance, the total savings achieved for the Medicare Trust Fund, our shared savings and our quality scores," said Anthony Valdés, president of Collaborative Health Systems. "Across the country, our ACO partners consistently demonstrate how physicians can thrive and retain their independence by embracing value-based care that increases accountability, improves quality and lowers costs."
"As today's providers continue to transition to value-based models, they are looking for innovative ways to improve health outcomes and lower costs," said Michael Polen, WellCare's executive vice president, Medicare and operations. "Our ACO partners are consistently demonstrating that when given the right tools, they can improve quality and lower the overall cost of care."
Medicare ACOs are groups of doctors, hospitals and other healthcare providers who come together voluntarily to provide coordinated high-quality care to their Medicare beneficiaries, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of healthcare dollars – it is able to share in the savings generated for Medicare.
About WellCare Health Plans Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 6.3 million members nationwide as of June 30, 2019. For more information about WellCare, please visit the company's website at www.wellcare.com.
About Collaborative Health Systems Collaborative Health Systems (CHS), a WellCare Company, is a management services organization that partners with independent primary care physicians as they move to value-based models. Its core belief is that primary care physicians are in the best position to influence the quality and cost of healthcare. CHS provides comprehensive support for its physician partners by providing management services, risk contracting, and population health capabilities, including actionable data and other tools, to deliver care coordination and closure of gaps in care. CHS provides additional services to secure and deliver favorable value-based contracts with commercial and other health plans. As of July 2019, CHS manages two Next Generation ACOs, nine MSSP ACOs, a Care Transformation Organization and two Independent Practice Associations. For more information, visit www.CollaborativeHealthSystems.com.