Philips and Accountable Care Organizations demonstrate value in Medicare shared savings programs

Accountable Care Organizations (ACOs) were designed with a promise: by banding together, physician organizations, hospitals, and other care delivery organizations could share risk, reduce costs, and deliver better holistic care to their patient populations. For the past decade, the industry has been trying to figure out the best path forward for ACOs, finding the best structure. In order for ACOs to become an industry standard, their outcomes must prove their value.

New data from the Centers for Medicare & Medicaid Services (CMS) not only demonstrates the overall value of Medicare Shared Savings Programs (MSSP) ACOs, but also highlights the value of a strategic population health management program. Philips supports multiple customers in various stages of risk sharing models and in 2018, six of Philips’ MSSP ACO customers generated a collective savings of $92M [1]. 

Over the course of the year, they also:

• Incurred $87M+ less in beneficiary expenditures compared to historical benchmarks;
• Earned $33M+ in shared savings; and
• Scored a 92% Quality Rate on average placing them in the 75th (top) quartile collectively. [1]

Philips Population Health Management (PHM) solutions and services partner with organizations participating in a variety of value-based care programs, including the Medicare Shared Savings Programs (MSSP). Designed to provide high-quality, coordinated care to improve outcomes and reduce costs, the MSSP is an alternative payment model in which eligible providers, hospitals, and suppliers are rewarded for achieving better health for individuals, improving population health, and lowering growth in healthcare expenditures. 

“Accountable care organizations are uniquely structured to help drive the tenets of the quadruple aim of improving patient outcomes, enhancing the patient and clinician experiences, and reducing the overall costs of care,” said Cindy Gaines, Clinical Leader, Population Health Management, Philips. “The successes achieved by several of our ACO customers in 2018 demonstrate that with the right combination of population health strategy and technology, organization support and clinician engagement, ACOs can help us transform how we deliver care.”

With measures centered on preventing hospital readmissions through wellness and chronic disease management programs, ACOs can benefit from population health management tools that bring together patient population data to help drive a more proactive approach to care. 

For example, many ACOs are challenged by scaling care management and aggregating data from disparate EHRs for patient and population views. Philips PHM solutions support a complete longitudinal record for all patients and members in a single technology platform, which helps break down artificial data siloes through aggregating, normalizing and risk stratifying data to provide a more complete view of the population. This also enables ACOs to focus on a system-wide approach to population health, where care delivery solutions can be effectively integrated to scale care management.

At the HIMSS 2020 Global Health Conference & Exhibition in Orlando, FL, Cindy Gaines, Clinical Leader, Population Health Management, Philips will be presenting with Cynthia Burghard, Research Director at IDC Health Insights, on “The Future of Population Health Management” at the Philips booth (#2701), on Tuesday, March 10th at 3:30pm ET. Healthcare professionals interested in learning more about how population health programs can drive better outcomes and reduced costs are welcome to attend. 

[1] Based on CMS publicly available data on Performance Year 2018 Medicare Shared Savings Program for Accountable Care Organizations customers of Philips Population Health. n=6.