UH Continues to Lead in Value, Based on Recent Results from the Medicare Shared Savings Program

CLEVELAND – University Hospitals continues to lead in value for its patients, with a recent quality score of 100 percent up from 97.4 percent in 2019 and 73.4 percent in 2018. The 2020 annual Medicare cost per member of $8,286 represents a 12 percent reduction from 2019 and 20 percent reduction from 2018, resulting in an $8.8 million payment from the Medicare Shared Savings Program (MSSP). This accomplishment marks the second consecutive year of successfully earning shared savings from the Centers for Medicare and Medicaid Services (CMS) under MSSP. (UH’s 2019 annual cost per member was $9,459 and in 2018 it was $10,389. In 2019, UH received $9.1 million in shared savings from CMS.)

“This is a testament to all our care givers for their increased focus on keeping patients healthy at home, rather than healing in a hospital,” said Peter Pronovost, MD, PhD, Chief Quality and Clinical Transformation Officer. “We continue to follow through on our strong commitment to be leaders in value. We aligned the entire organization around value, made defects in value visible and designed systems to reduce those defects. The 20 percent reduction in annual cost from 2018 is both hopeful and humbling. With 30 percent of healthcare spending estimated to be waste, we are hopeful that our approach was able to reduce spending by 20 percent. We are also humbled that it can and will make care so much better.”

Performance data recently released by CMS show that in the 2020 performance year, UH Coordinated Care Organization (UHCCO), the hospital system’s Medicare Accountable Care Organization (ACO), achieved a quality score of 100 percent. Only 71 out of 513 ACOs nationwide achieved this quality score, and of those 71 ACOs, UH’s had the fourth lowest cost.

“This demonstrates our continued efforts to achieve the triple aim of population health: improve the health of populations, improve patient experience and reduce the total cost of care,” said Mark Schario, Vice President, Population Health & President, UHCCO. “CMS recognized that UH improved the quality of care for more than 47,000 Medicare beneficiaries across Northeast Ohio, while also reducing their total cost of care.”

“These results reflect the tremendous positive impact felt by our patients and their families,” said Dr. Pronovost.

“Through the hardships of the COVID-19 pandemic, our physicians, clinical and non-clinical teams continue to go above and beyond to provide outstanding preventative care to our patients. The staff supporting these efforts, including our nurses, patient navigators, social workers, pharmacists and many others, continue to be critical to the success of this program. It is breathtaking to witness such commitment to providing quality and high value care to our patient population,” Dr. Pronovost said.

A cultural change within the organization shifted the focus of care towards population health and the importance of keeping patients healthy at home, rather than healing in a hospital; a new narrative passionately adopted by UH upon the arrival of Dr. Pronovost.

The Medicare ACO Shared Savings Program is the largest value-based payment model in the country and a critical tool in moving the health system toward better value.

A fact sheet with more information about MSSP ACOs is available online, along with other resources — All About ACOs — and the ABCs of ACOs.