Partners HealthCare, one of the original Pioneer Accountable Care Organizations (ACO), has successfully lowered costs and improved the quality of care provided to approximately 88,000 Medicare patients, according to new federal data released. The Pioneer ACO initiative, sponsored by the Center for Medicare & Medicaid Services (CMS), aims to transform the way that health care is delivered by providing Medicare patients with higher quality care, while slowing cost growth through enhanced care coordination.

Over the past five years, Partners’ efforts have reduced costs of care for Medicare by $36.7 million (of which Partners has received $20.4 million). In the fifth year of participation, Partners was successful in slowing the rate of cost growth by 0.5% as compared with the benchmark that Medicare used to measure Partners’ performance. This translates into approximately $5.2 million in gross savings. The federal government also highlighted several notable improvements in specific categories. Partners’ growth in expenses for patients aged 65 and over, for both those who are not dually eligible for Medicare and Medicaid (consisting of 82% of total members), and those who are dually eligible for Medicare and Medicaid was lower than their ACO benchmark (a reduction of 1.0 and 1.9 percentage points respectively). Partners attributed the reduction in expenses to the high risk care management program, which assigns nurse care managers to care for chronically ill patients with multiple medical conditions, and is helping to lower costs and improve care.

Partners also trended better than the benchmark in inpatient and professional care as well as skilled nursing facility expenditures. The growth in inpatient expenditures was 4.6 percentage points lower than the growth in the national Medicare population from the prior year. Hospice use among the Partners network has increased, indicating more of our patients are benefitting from this important service.

As in previous years, Partners continues to deliver high quality care to Medicare patients. Partners scores well in nearly all quality indicators that the federal government tracks as part of the Pioneer ACO initiative. With an overall quality score of 94.51%, Partners is among the best ACOs in the nation for delivering high quality care to patients. Partners achieved consistent results over all measures, scoring over 90% in all four quality domains, and showed significant improvement in the majority of hospital admissions related measures.

These results show that our investment and focus on population health as a key strategy to improve care and reduce costs has been well worth it.

Sree Chaguturu, MD Vice President, Center for Population Health, Partners HealthCare

“We have made significant strides in transforming the way we deliver care, particularly with our high-risk care management program,” says Sree Chaguturu, MD, Vice President, Center for Population Health, Partners HealthCare.

These results reflect the final year of performance data for the Pioneer ACO program, which has been phased out by CMS. Partners HealthCare has chosen to continue to optimize the care for Medicare patients under a similar CMS initiative called the Next Generation ACO Model. Similar to previous ACO models, the Next Generation ACO Model rewards providers and health care organizations for delivering high quality, coordinated care, while keeping costs on par with a national spending benchmark. The Next Generation ACO Model also includes several new care delivery components and financial risk options for organizations with prior experience managing populations of patients.

“We look forward to continued participation in the ACO program with the Next Generation ACO Model and the new opportunities it offers for primary care physicians and specialists to collaborate,” says Gregg Meyer, MD, Chief Clinical Officer, Partners HealthCare. “With five years of experience as a Pioneer ACO we are in a good position to continue to improve the health of our Medicare patients.”

For more information on Partners’ ACO, click here. To learn more about population health, click here.