WellCare ACOs Led by Primary Care Physicians Saved $90.5 Million for Medicare Program and Generated $43.6 Million Shared Savings Revenue
Improvements Continue in Quality, Savings and Ability to Manage Risk
WHITE PLAINS, N.Y. and TAMPA, Fla., Dec. 5, 2017 /PRNewswire/ -- Collaborative Health Systems (CHS), a WellCare company (NYSE: WCG), announced today that 11 Accountable Care Organizations (ACOs) that CHS formed in partnership with primary care physicians earned more than $43.6 million in shared savings as part of their participation in the Medicare Shared Savings Program (MSSP) for program year 2016. The amount of shared savings represents a 9.5 percent increase over what the CHS-affiliated ACOs generated last year.
These 11 ACOs qualified for shared savings payments for program year 2016 and met quality standards and savings thresholds established by Medicare. Six of those 11 ACOs are Track 2 MSSP ACOs in which providers take on more financial risk. CHS was the only sponsor of Track 2 MSSP ACOs in the country for program year 2016. Four other ACOs achieved savings for CMS but did not exceed the minimum savings threshold to qualify for a shared savings payment. Together, these 15 ACOs generated $90.5 million in total savings for the Medicare program.
ACOs are groups of providers that voluntarily come together to coordinate care and take responsibility for the cost and quality of their patients' healthcare. ACOs formed with CHS, the largest Medicare ACO sponsor in the country through program year 2017, have generated more than $248 million in net savings to the Medicare Trust Fund since 2012, the first year of the program.
Quality scores among CHS ACOs continued to be strong with an average score of 92.9 percent across all of the company's ACOs, steadily increasing each year. Medicare's quality measures help assess healthcare processes, outcomes, patient experience and organizational structure that are associated with the ability to provide high-quality healthcare. CHS ACOs' improvements were most noticeable in scores measuring fall risk assessment, depression screening and follow-up, tobacco use and cessation, and diabetes eye exams.
Jeffery Spight, president of Collaborative Health Systems, commented on the strong performance. "Our 2016 results demonstrate our model of engaging providers to achieve better health outcomes and lower costs is working. The legacy of our business, going back more than 16 years, is rooted in strong partnerships with providers, mostly primary care physicians, and using our data platform and care management protocols to help providers gain greater insight and control over the cost and care of their patients in their communities," said Spight. "It's gratifying to see our provider partners be rewarded for embracing change and making a commitment to the new value-based payment models that prioritize positive quality and cost results. We also are pleased to see our providers in Track 2 ACOs perform so well. These providers have proven they can take on progressively higher levels of risk, while lowering costs and maintaining high quality."
Ken Burdick, WellCare's CEO, said the company is excited about CHS' demonstrated success in engaging with providers to embrace quality and cost reforms. "WellCare's number one focus is the health and well-being of our members, and we are pleased with the positive impact our ACO provider partners have on Medicare beneficiaries' health as demonstrated in the 2016 results," said Burdick. "CHS' successful approach with ACO providers and their Medicare beneficiaries represents what's possible when providers and beneficiaries come together through this new model of care: more contact between primary care physicians and their patients, more coordination with specialists and other providers in the community, and a greater focus on prevention and wellness."
About Collaborative Health Systems
Collaborative Health Systems (CHS), a WellCare company (NYSE: WCG), is a management services organization that partners with primary care physicians as they move to value-based payment systems. Our 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 actionable data to help coordinate care and helping practices change behavior to meet the new quality requirements of the value-based payment system. In 2017, CHS manages two Next Generation Model ACOs and 16 MSSP ACOs, with more than 4,200 providers, mostly primary care physicians, covering 222,000 Medicare beneficiaries. In addition, CHS partners with physician groups that have come together to form Independent Physician Associations (IPAs). For more information, visit www.CollaborativeHealthSystems.com.
About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. The company serves approximately 4.3 million members nationwide as of September 30, 2017. For more information about WellCare, please visit the company's website at www.wellcare.com or view the company's videos at www.youtube.com/user/WellCareHealthPlan.
SOURCE WellCare Health Plans, Inc.
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