Announcement is Part of New Findings Released by CMS on its Healthcare Reform Initiatives
NEW YORK (January 31, 2014) –Montefiore Medical Center, a premier academic medical center and the University Hospital for Albert Einstein College of Medicine, today announced its strong success in delivering quality care with improved outcomes at a lower cost for Medicare patients as part of the Pioneer Accountable Care Organization (ACO) Model. A new analysis shows Montefiore's ACO generated substantial savings for the Medicare program, representing the highest financial performance among all Pioneer ACOs. Data also showed that monthly Medicare spending per beneficiary among Montefiore ACO participants represented a savings of $104 compared to monthly spending per beneficiary among a local market comparison group.
"We are proud to be the top financial performing Pioneer ACO in year one and prouder still of the outcomes and experience of care we provide to our patients, their families and the communities in which they live," said Steven M. Safyer, M.D., president and CEO, Montefiore. "Montefiore's experience demonstrates to the nation that positive change is, indeed, possible. We applaud CMS' efforts to support and evaluate new approaches to care that can form the basis of an improved healthcare system for all Americans."
Savings were achieved through increased patient engagement, care coordination and preventative, patient-centered care provided wherever needed – in the hospital, in doctors' offices, by phone and at home. Innovative nurse-driven interventions supported patient outcomes and experience. Through a unique collaboration with physicians in the community and across Montefiore's healthcare system, Montefiore ensured clinical excellence at all points of care.
"We are pleased to demonstrate that the ACO model can be effective in reducing health spending," said Stephen Rosenthal, vice president, network management, Montefiore. "We attribute our success to our more than 17 years of experience using a value-based payment model and the fact that we achieved the Triple Aim of excellent care, improved outcomes and lowered costs."
An independent preliminary evaluation of the Pioneer ACO Model showed gross savings of $147 million in the first year. Results showed that of the Pioneer ACOs, nine had significantly lower spending growth relative to Medicare fee for service while exceeding quality reporting requirements. These savings far exceed findings from a previous analysis conducted by the Centers for Medicare and Medicaid Services (CMS), which used a different methodology.
"Early in Montefiore's ACO development, we created a predictive analytics model that assists in the identification of patients who will benefit from advanced interventions," said Andrew D. Racine, M.D., Ph.D., senior vice president and chief medical officer, Montefiore. "This focus on data analytics has been instrumental in enabling Montefiore to provide proactive care suited for each individual patient's needs. By focusing on the right care for the right patient at the right time, we were able to substantially reduce admissions and all-cause 30-day readmissions."
Findings were released by CMS on healthcare delivery system reform initiatives and included interim financial results for the Medicare Shared Savings Program ACOs, an in-depth savings analysis of Pioneer ACOs, results from the Physician Group Practice demonstration and participation in the Bundled Payments for Care Improvement Initiative. CMS contracted with L&M Policy Research to evaluate the impact of the Pioneers on Medicare spending between 2011 and 2012. Reported spending was $20 less per beneficiary per month among Pioneer ACO beneficiaries on average, compared to local market comparison groups.