Network earns perfect quality score, saves Medicare more than $4 million
The Centers for Medicare & Medicaid Services (CMS) recently released performance data for Medicare Shared Savings Program (MSSP) ACOs for performance year 2021. For a second year in a row, Banner Network Colorado (BNC) providers not only continued to deliver exceptional patient care for its more than 6,100 Medicare Fee-For-Service beneficiaries in Colorado last year, but also helped save Medicare $4.6 million by continuing to meet quality and cost goals. While the average cost of savings is 4.29% for Colorado MSSP ACOs, BNC exceeded that with a savings of 7.82%. BNC is part of the Advanced Track MSSP which is the highest level of financial risk in the program.
According to the CMS data, BNC received a perfect quality score of 100% earning high quality scores on performance measures that include diabetes, blood pressure control, breast cancer and prevention of cardiovascular disease, among others. The $4.6 million of gross savings to Medicare resulted in a shared savings payment of $2.28 million to BNC for its participating providers who support care for these Medicare beneficiaries. The shared funds help support the employment of additional in-office resources such as nurses, medical assistants and pharmacists which helps improve the care being delivered to these patients.
Several of BNC’s participating primary care clinics have partnered with CMS since 2012, piloting several alternative payment models designed to improve the care and outcomes of Medicare beneficiaries in northern Colorado markets.
“We’re committed to find ways to enhance our services and treatment options for patients and we couldn’t achieve these results without a network of exceptional doctors and health care providers who are focused on reducing the cost of care without compromising quality,” said Ed Clarke, MD, CMO for Banner’s Insurance Division. “I am proud that we are being recognized as a leader for providing quality health care and honored to be a part of a dedicated group of health care professionals who are working toward helping people live longer and healthier lives.”
A market-based solution to fragmented and costly care, ACOs empower local physicians, hospitalists and other providers to work together and take responsibility for improving quality, enhancing patient experience and keeping care affordable. The Medicare Shared Savings Program (MSSP) creates incentives for ACOs to invest in transforming care by allowing them to share in savings they generate after meeting defined quality and cost goals.
To achieve these results, primary care practices and providers within BNC strive to increase the number of Medicare beneficiaries taking advantage of annual wellness visits, including recommended screenings and preventive care. The ACO also focuses on ensuring smooth patient transitions from the hospital to home—or a nursing home if needed. All ACO providers receive detailed information about their performance on quality measures. And clinicians and providers share best practices to coordinate the care beneficiaries receive from different primary care and specialty providers and to prevent health issues and repeat hospitalizations.
Network Colorado includes more than 300 primary care providers and specialists who serve communities in Northern Colorado,
Banner Network Colorado (BNC) is a provider network serving health care policyholders in Larimer and Weld counties in Northern Colorado’s Front Range. The network is composed of health care providers such as physicians, hospitals and related medical providers who are linked together to improve the quality of care for patients. These providers make a commitment to work closely together to coordinate all aspects of a patient’s care, to enhance the patient experience and to improve outcomes. Nearly 300 providers are currently participating in Banner Network Colorado.