Medicare grants 8 million to Philadelphia-area organizations for reducing costs and meeting healthcare quality benchmarks.
In a significant development for healthcare in the Philadelphia area, physician organizations associated with Medicare have collectively received over 8 million in bonuses for 2023, reflecting their success in delivering quality care that helps save costs for the Medicare program. This information emerges from newly released federal data, showcasing the effective performance of local healthcare providers under the Medicare Shared Savings Program (MSSP).
For the second consecutive year, the top performer among the local physician groups was an Accountable Care Organization (ACO) known as Aledade Accountable Care 15 LLC. This group operates clinics in the western suburbs of Philadelphia and is affiliated with Aledade, a national company based in Maryland that specializes in assisting independent primary care physicians in managing their Medicare patient populations.
The Aledade ACO is one of 13 local ACOs participating in the MSSP, which aims to reduce healthcare costs while improving patient care quality for millions of Americans enrolled in traditional Medicare. These ACOs are structured in a way that allows doctors to earn bonuses based on their performance in meeting established cost and quality benchmarks, covering key areas such as preventive care and chronic disease management.
Collectively, the 13 local ACOs enrolled approximately 256,000 patients and achieved a total of 7.6 million in bonuses. Nationally, a total of 477 ACOs managed 10.3 million patients and earned a remarkable .1 billion in performance bonuses, effectively saving Medicare around .4 billion compared to established cost benchmarks.
While the Shared Savings Program currently serves fewer beneficiaries than the 34.1 million individuals enrolled in private Medicare Advantage plans, both programs share the common objective of enhancing patient care management, thereby resulting in cost savings and improved healthcare quality.
Aledade Accountable Care 15 LLC reported an impressive savings rate of 16.6%, which translated into a bonus of million while providing services to 21,249 patients. Although the number of patients served has declined by 10% compared to the previous year, this ACO continues to serve individuals beyond the Philadelphia region.
The region’s largest ACO is a joint venture involving Thomas Jefferson University, Main Line Health, and insurer Humana, known as the Accountable Care Organization of Pennsylvania. This partnership achieved a savings rate of 6.4%, resulting in a bonus of million for serving 74,756 patients, which represents nearly a 50% increase in bonuses compared to the previous year.
Tandigm Value Partners, another local ACO operated by Tandigm Health, showcased notable improvement in its performance, reporting a savings rate enhancement from 8.4% to 13.4%. Meanwhile, a newly initiated ACO managed by Tandigm, known as Penn Medicine Healthcare Partners, recorded a savings rate of 1.6% in its inaugural year, securing a .3 million bonus.
Physician groups are expected to reinvest their shares of these bonuses into their practices, contributing to the sustainability and quality of healthcare services. Under the Affordable Care Act, Medicare retains a portion of the savings generated through this program, further underscoring the system’s commitment to promoting efficient and effective healthcare delivery.
This robust performance by the Philadelphia area’s ACOs underscores a growing trend in healthcare management aimed at improving patient outcomes while simultaneously controlling costs, thereby paving the way for future innovations in the healthcare industry.
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