Southwestern Health Resources ACN rates No. 1 in Medicare savings
The Southwestern Health Resources Accountable Care Network (SWHR ACN) saved almost $30 million in 2017, according to the Centers for Medicare & Medicaid Services (CMS). These savings place it at the top of organizations participating in the CMS Next Generation Accountable Care Organization (ACO) Model. The savings resulted in an overall quality score of 100 percent for that fiscal year.
The SWHR ACN is one of the 44 ACOs participating in the Next Generation ACO Model, Medicare’s highest-risk ACO model. These ACOs generated more than $208 million in gross savings, including discounts to Medicare, according to 2017 performance data made public from CMS. The SWHR ACN’s results represent more than 14 percent of total savings generated by all Next Generation ACOs.
The SWHR ACN manages care for nearly 69,000 Medicare beneficiaries in North Texas aligned through the Next Generation ACO Model. This is more than any other ACO in North Texas. With this Model, CMS sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care, and aims to attain the highest-quality standards of care. In accordance with the Department of Health and Human Services, this accountable care model is evaluated on its ability to deliver better care for individuals, better health for populations, and lower growth in expenditures.
“The delivery of tens of millions of dollars in savings while maintaining top-tier quality care for Medicare beneficiaries speaks to the thoughtful strategies our network has consistently initiated and widely embraced to improve efficiency in the delivery of care,” said Dr. Daniel K. Podolsky, President of UT Southwestern, who Co-Chairs Southwestern Health Resources with Barclay Berdan, FACHE, CEO of Texas Health Resources.
“Being ranked No. 1 in the nation for the most recent performance results further validates the success of the physician-driven strategies the SWHR ACN has designed to build a stronger system of care. While we’ve achieved significant savings, we also have focused on improving the quality of care delivered to patients to accomplish this,” said Dr. Mack Mitchell, Chief Medical Officer, Southwestern Health Resources Physician Network.
Since 2015, the SWHR ACN has been among the country’s top-performing programs. It was approved in 2017 to participate in the Next Generation ACO Model.
Prior to this, the SWHR ACN achieved successful performance results as part of the CMS Medicare Shared Savings Program (MSSP), the national initiative to reduce costs by coordinating and delivering better health care for Medicare patients. This included delivering cumulative savings of $73 million during a three-year period (for 2014, 2015, and 2016), combined with maintaining a top-decile quality score in the 95th percentile nationally. SWHR ACN’s quality scores improved 5 percent among established measures and 13 percent on preventive measures.
The ACN includes UT Southwestern faculty, Texas Health Physicians Group members, and independent community physicians. Formerly called the UT Southwestern Accountable Care Network (UTSACN), the organization was among the first to participate in the CMS MSSP.
Southwestern Health Resources, which was formed in 2016 by Texas Health Resources and UT Southwestern, blends the strengths of both partners – from preventive care to the most advanced interventions. Southwestern Health is made up of a physician network, hospital network, and a population health services company.
The Southwestern Health Resources network includes 30 hospital locations and more than 4,000 physicians across 16 counties in North Texas. In total, Southwestern Health ACN coordinates care for more than 600,000 patients, aligned with commercial health care plans and Medicare programs.