PHOENIX (Oct. 3, 2023) — Performance data for Medicare Shared Savings Program ACOs was recently released by the Centers for Medicare and Medicaid Services (CMS). For 2022, Banner Health Network (BHN) providers not only achieved the highest earnings among Arizona ACOs, but also helped Medicare save $22.9 million by continuing to meet quality and cost goals. 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 that exceeded the average score for all ACOs and is in the top 10% compared to ACOs nationally. Quality scores are earned on performance measures that include diabetes, blood pressure control, breast cancer screening and prevention of cardiovascular disease, among others. The $22.9 million of gross savings to Medicare resulted in a shared savings payment of $16.8 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 nearly $200 million in savings to Medicare while continuing to see an upward trend to quality scores. BHN shared in this savings for 10 of the past 11 years.
“Our group of providers are truly exceptional as they continue to focus on helping Medicare save millions of dollars while also delivering quality care for our nearly 70,000 Medicare Fee-For-Service beneficiaries,” said Ed Clarke, MD, chief medical officer for Banner’s Insurance Division. “We’re always striving to meet or exceed quality and cost goals which can be complex and a herculean task since we serve the largest number of beneficiaries in Arizona.”
Recently, BHN was recognized by Becker’s Hospital Review in its “36 ACOs to know” list. The list acknowledges those ACOs for helping patients and health systems save millions of dollars annually while providing quality care at reduced costs.
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 transforming 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 between care settings, for example from the hospital to home. 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.