The Centers for Medicare & Medicaid Services (CMS) today announced the 2015 performance year results for the Medicare Shared Savings Program and the Pioneer Accountable Care Organization Model that show physicians, hospitals and health care providers participating in Accountable Care Organizations continue to make significant improvements in the quality of care for Medicare beneficiaries, while achieving cost savings.

In 2015, Medicare Accountable Care Organizations had combined total program savings of $466 million, which includes all Accountable Care Organizations’ experiences for 392 Medicare Shared Savings Program participants and 12 Pioneer Accountable Care Organization Model participants. The results show that more Accountable Care Organizations shared savings in 2015 compared to 2014, and those with more experience tend to perform better over time.

Medicare ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated high quality care to their Medicare patients. The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO exceeds quality and financial thresholds – demonstrating achievement of high-quality care and wiser spending of health care dollars – it is able to share in the savings generated for Medicare.

Premier Patient Healthcare LLC (Premier) ACO, one of the ACOs that shared savings in 2015, began its journey in December 2012 with seven physician members who had a vision of building a better care-delivery model for physicians and patients in North Texas. Since then, it has grown to become over 500 physicians strong, becoming a Medicare Shared Savings Program (MSSP) ACO in 2014.

With $12.7 million in shared savings in 2015, Premier is distinguished with the following rankings:

• #1 highest savings generated by a physician-owned 2014 MSSP ACO startup in Texas and Oklahoma
• Fourth highest savings generated across the U.S. by MSSP ACOs starting in 2014.
• Top 10% in shared savings earnings among all MSSP ACOs for 2015.

“Premier’s continued success under the Medicare Shared Savings Program is a testament to the vital importance of the independent physician to the healthcare ecosystem,” said Deepak Jaiswal, M.D., Chairman of the Premier PHC ACO Board of Directors. “Many believed at the launch of the Affordable Care Act that savings and innovation would come from the consolidation of larger institutional organizations. And though we have seen a significant move toward such consolidation, it’s the leaner, independent ACOs like Premier who have been able to quickly adapt to the new value-based care model, and lead the charge for quality improvement and savings.”

“Physicians want to be part of something bigger and more organized in a new era of healthcare without having to sacrifice autonomy and the ability to guide patient care,” continued Dr. Jaiswal. “Premier ACO was built by physicians, for physicians to meet this need. Because they are building something for themselves, our partner physicians have been willing to work harder and more closely together with other physicians and ancillary partners, embracing new ways of delivering more-effective patient care.”

Based upon this strong, collaborative foundation Premier continues to create new programs and adapt technology to advance care that improves patient health while subsequently controlling costs. 

“Our model, as powered by Premier’s proprietary 360 Population Management suite and our coordinated care programs have steadily improved patient outcomes and utilization,” said Mohammad Sohail, Chief Information Officer of Premier PHC ACO. “Through the powerful predictive modeling technology built into our 360 suite, our providers are able to identify those patients who are at greater risk for declining health and adverse conditions that can lead to hospitalization. The physician then deploys our stepwise coordinated care programs - which incorporate clinical and non-clinical factors - to disrupt and reverse declining health. This method provides for better care and more positive patient outcomes, helping our most at-risk patients stay healthier and out of the hospital, increasing their quality of life while organically driving down costs.”

Premier has built a structured system that works to deliver quality care at all patient touchpoints.  Premier guides care through preferred ancillary partners such as labs, imaging centers, home health and transitional/post-acute care providers who all share a common vision for coordinated, cost-effective care.  It’s a system that works, as evidenced by the $12.7 million in health care savings generated by the ACO in 2015.

In 2015 Premier also launched a groundbreaking program in collaboration with Texas Health Resources, placing 18 Premier specialty physicians known as hospitalists at key Texas Health hospital locations. When Premier patients are admitted to a partner hospital, the hospitalist acts as their dedicated physician, overseeing their treatment, collaborating with their primary physician and ensuring that the patient stays within our circle of care, across all care settings. 

This is only the beginning for Premier as their model is purposely replicable. This scalability contributes to continued MSSP success, while driving expansion to other arenas within healthcare as well, including our collaborative subsidiary Premier Physician Group, commercial ACOs, Medicare Advantage contracts, and new brick and mortar, one-stop, multi-specialty health centers.

Although 2015 cost-savings are remarkable and cause for celebration, the real winners are the patients and Premier Partner physicians. The patients enjoy higher-quality care, better health and improved quality of life. Premier’s partner physicians share in a portion of achieved savings, but find even greater reward in a renewed connection with patients and heightened enjoyment and satisfaction in the practice of medicine.

About Premier Patient Healthcare LLC
Premier Patient Healthcare LLC is a licensed Medicare ACO serving five regions in North Texas and Southern Oklahoma. Premier is a physician-owned, physician-led and patient-driven organization providing coordinated services to its beneficiaries, increasing quality while reducing cost. Premier ACO is accountable for more than 47,000 Medicare beneficiaries. As an ACO, Premier agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program, while allowing the member physicians to maintain their independence. To learn more about Premier PHC ACO visit www.premierphc.com. To learn more about Premier collaborative partnerships under subsidiary Premier Physician Group, visit http://www.premierphcpg.com.

Additional Resources

Visit the Medicare Shared Savings Program News and Updates webpage to access the CMS press release and fact sheet, the link to the Performance Year 2015 results file, and to learn more about the program.