Universal Health Services (UHS) announced the 2018 results of its seven UHS Accountable Care Organizations (ACOs), including the Silver State ACO, showing a continued trend of increased cost savings and improved quality.
The Silver State ACO represents 44 practices in northern and southern Nevada and has earned shared savings for four consecutive years (2015 to 2018). It is ranked first in Nevada for program savings with $33.9 million, and it is ranked in the top two percent nationally. Silver State ACO is partnered with Northern Nevada Health System and the Valley Health System in Southern Nevada.
What Are ACOs?
ACOs are groups of physicians who agree to reduce costs and increase quality within a value-based contract, which results in a shared savings agreement. Physicians are incentivized to bend the healthcare cost curve, manage utilization and maintain high quality care by shifting from volume-based payments to value-based payments. Within the shared savings program, providers can earn back part of the savings they generate for Medicare by hitting pre-determined spending goals.
UHS ACOs are physician-led and hospital-sponsored, centered on primary care with community partnership in post-acute and specialty care. Hospital sponsorship is a differentiator in UHS ACOs as the hospitals provide capital funding, partnership in downside risk and integrated ACO-friendly hospital initiatives focused on avoiding unnecessary utilization and increasing communication with ACO providers. The support from UHS facilities allows for ACO leadership and governance to be driven by participating providers in the community—a vital component to success in value-based care.
“Physicians with the Silver State ACO have worked tirelessly to focus on high-value activities for our patients to better manage their health,” said Karla Perez, Vice President at UHS overseeing the Nevada market, which includes the Valley Health System and Northern Nevada Health System.
UHS also provides administrative oversight and data analytics for ACO operations in addition to ACO-friendly hospital initiatives within each UHS facility. These initiatives include PCP notification of ACO beneficiary admit/discharge, ACO patient flags within the hospital EMR, partnerships with hospitalists and ED providers to ensure appropriate utilization, and integrated case management navigating PCP communication and post-acute care.
The Center for Medicare and Medicaid Services established the ACO program to improve the quality of care for Medicare beneficiaries and lower Medicare costs. If an ACO achieves high quality and saves money for Medicare, then the ACO shares in those savings. Since the beginning of the ACO program in 2013, ACOs have saved Medicare $2.66 billion.