Premier Inc. Statement on CMS ACO Results Last Updated: October 18, 2017
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By Joe Damore, Premier’s vice president of population health management

Premier Inc. commends the continued successes of leading healthcare providers participating in the Centers for Medicare & Medicaid Services Next Generation Accountable Care Organization (ACO) and Pioneer Programs for their progress in improving the health of a Medicare population, reducing healthcare costs, and leading the change from a volume-based, sickness-focused model to a value-based, wellness-focused health system. These organizations have achieved a savings to Medicare of nearly $140 million across both programs in PY16 and hundreds of millions of dollars in just five years. These results demonstrate that value-based care and payment can successfully lead to better care and improved health and outcomes at a lower cost – when the conditions are right. In fact, all five Next Generation and Pioneer ACOs participating in Premier’s Population Health Management Collaborative achieved shared savings, representing 33 percent of the total savings but just 19 percent of the program participants. We applaud the following Premier collaborative members for their leadership, successful results and outstanding work:

  • Banner Health of Phoenix
  • Baystate Health of Springfield, Massachusetts
  • Fairview Health Services of Minneapolis
  • Henry Ford Health System of Detroit
  • Triad Health Network/Cone Health of Greensboro, NC

However, the results also prove that success in advanced, two-sided risk models is challenging to achieve on a consistent basis due to complex variables and antiquated policies. Part of this is the result of the continuation of public policies that impede success, such as the lack of waivers from antiquated fee-for-service rules, barriers to helping beneficiaries choose best settings for post-acute and other care, incomplete access to complete patient claims information for coordinated care management, limits to beneficiary engagement services such as waived co-pays or meal/transportation vouchers, and the complexity and incompatibility of various federal programs with one another and private payer contracts. These issues urgently need to be addressed and resolved with provider input in order to ensure continued success and further savings for the Medicare program, particularly as more providers look to two-sided risk models in order to capture incentive payments, as promised in the MACRA Quality Payment Program.

— Joe Damore, Premier’s vice president of population health management