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.
View original content with
multimedia:http://www.prnewswire.com/news-releases/wellcare-acos-led-by-primary-care-physicians-saved-905-million-for-medicare-program-and-generated-436-million-shared-savings-revenue-300566211.html
SOURCE WellCare Health Plans, Inc.