PHOENIX— The Centers for Medicare & Medicaid Services (CMS) recently released performance data for Medicare Shared Savings Program (MSSP) ACOs for performance year 2021. Banner Health Network (BHN) providers not only continued to deliver exceptional patient care for its nearly 70,000 Medicare Fee-For-Service beneficiaries in Arizona last year, but also helped save Medicare $34.8 million by continuing to meet quality and cost goals. While the average cost of savings is 4.17% for Arizona MSSP ACOs, BHN exceeded that with a savings of 5.03%. BHN is part of the Advanced Track MSSP which is the highest level of financial risk in the program.
According to the CMS data, BHN received a quality score of 98.93% to earn high quality scores on performance measures that include diabetes, blood pressure control, breast cancer and prevention of cardiovascular disease, among others. The $34.8 million of gross savings to Medicare resulted in a shared savings payment of $25.6 million to BHN, half of which will be distributed to accountable care physicians who participate in Medicare Shared Saving Program.
BHN has partnered with the Centers for Medicare & Medicaid Services since 2012 and has generated more than $176 million in savings to Medicare while continuing to see an upward trend to quality scores. BHN shared in this savings for 9 of the past 10 years.
“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, hospitals 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 transform care by allowing them to share in savings they generate after meeting defined quality and cost goals.
To achieve these results, BHN providers work 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. Banner Health MSSP Network includes nearly 1,000 primary care providers who serve Maricopa and Pinal counties, joining with both Banner employed and community-based physician practices.
Banner Health Network was designed to provide a highly coordinated patient care experience for beneficiaries of government and private insurance plans. BHN is comprised of more than 5,000 Banner Health-affiliated physicians, 15 Phoenix-area Banner hospitals, and a variety of other clinical services and facilities arranged into eight “neighborhoods” across Arizona’s Maricopa County and parts of Pinal County. With engaged physicians, a population health management focus and sophisticated health information technology as support, Banner Health Network seeks to provide high quality care at an affordable price. Parent company, Banner Health, is one of the largest nonprofit health systems in the country, with operations in six states.