MyHealth First Network: Medicare Shared Savings Program Performance Year 2015 Quality and Financial Results

CONTACT: Karen Potter

(864) 797-7558

The Centers for Medicare & Medicaid Services (CMS) announced yesterday the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model that show physicians, hospitals and health care providers participating in Accountable Care Organizations continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.

In 2015, Medicare Accountable Care Organizations had combined total program savings of $466 million, which includes all Accountable Care Organizations’ experiences, for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more Accountable Care Organizations shared savings in 2015 compared to 2014, and those with more experience tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, 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 health care dollars – it is able to share in the savings generated for Medicare.

MyHealthFirstNetwork (MyHFN) is one of the ACOs that shared savings.

“MyHealth First Network was successful at generating more than $17 million in savings while improving the quality of care for nearly 60,000 Medicare beneficiaries. This is quite an achievement considering only about 19 percent of ACOs achieve shared savings in year one,” said Angelo Sinopoli, MD, president of MyHFN. “I am proud of our providers and what we have achieved. We have made great strides in delivering better care, spending dollars more wisely and helping improve the overall health of our community.”

In addition to those ACOs that shared savings, some ACOs had assigned beneficiary expenditures that were either greater than or less than their updated benchmark, but that fell within their minimum savings rate corridor. This means that they did not earn a performance payment.

Additional Resources

Visit the Medicare Shared Savings Program News and Updates webpage to access the CMS press release and fact sheet, the link to the Performance Year 2015 results file, and to learn more about the program.