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APG Member Organizations Participating in Innovative Model to Save Money for Taxpayers, Improve Quality for Medicare Patients

Nov 28, 2022 9:00:00 AM | APG Member Organizations Participating in Innovative Model to Save Money for Taxpayers, Improve Quality for Medicare Patients

APG Member Organizations Participating in Innovative Model to Save Money for Taxpayers, Improve Quality for Medicare Patients

New CMS report shows that participants in the Direct Contracting model in 2021 generated $70 million in net savings while achieving perfect quality scores

Washington, DC – A number of member organizations of America’s Physician Groups (APG) are among the 53 Direct Contracting Entities (DCEs) that generated $70 million in net savings for the Medicare program in 2021, according to newly released results from the Centers for Medicare & Medicaid Services (CMS). According to CMS, 38 DCEs (72%) also earned shared savings totaling $47 million, and all 53 of the DCEs participating in the Global and Professional Direct Savings Model (GPDC) attained quality scores of 100 percent in such areas as patient satisfaction and unplanned admissions for patients with chronic conditions. Collectively, these results constitute some of the strongest achieved to date by the advanced alternative payment models tested by the federal government.

The APG member organizations participating in the model and achieving net savings for the federal government and optimal quality scores include physician practices affiliated with agilon health; Castell Direct LLC, a division of Intermountain Healthcare; Collaborative Health Systems; Heritage Provider Network; Iora Health/One Medical; Sutter Health Foundation; and VillageMD.

“APG is pleased and proud that so many of our member organizations are among the 53 DCEs that recorded savings for the Medicare program, earned shared savings payments, and achieved perfect quality scores according to the GPDC model metrics in the first performance year,” said Susan Dentzer, APG President and CEO. “This important early evidence reinforces the concept behind this model: that its strong financial incentives encourage physician practices to transform care delivery; better manage and engage patients; and achieve higher quality-of-care outcomes than are typical for Medicare patients in the traditional fee-for-service program.”

APG members participating in the model pointed to their ability to achieve such robust results for patients and the government despite demanding circumstances.

“We’re proud that our participation as one of CMS’ Direct Contracting Entities yielded improved healthcare savings while earning perfect quality scores for Medicare patients. The results show that our physicians who consistently provide high-quality value-based care as their method of care delivery substantially reduce the cost to the Medicare system, which can reduce patients’ medical misery,” said Clive Fields, MD., Chief Medical Officer of VillageMD. “Next year’s program builds on the health equity components to close gaps in care for underserved communities.”  

“We are pleased that the Direct Contracting Entities were collectively able to show strong performance in the first year of the program, despite ongoing challenges from COVID and the steep investments required to activate such a large program,” said Suzanne Hansen, One Medical’s Chief Medicare Program Officer. She noted that One Medical/Iora achieved a high 4.93 percent net savings rate, results that “speak to the strong team and capabilities we have developed to support our patients.”

The Global and Professional Direct Contracting Model was revised and renamed the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH), and thus is the first accountable care model in Medicare to directly address issues related to health equity and access. An additional group of APG members has now entered the ACO REACH model as well. ACO REACH participants will be held financially accountable for the total health and cost of care for the fee-for-service Medicare patients who are attributed to them either through claims or voluntary alignment. The model provides for a holistic, accountable approach to treating Medicare beneficiaries, improving care for those with chronic conditions, addressing their social needs related to health and health care, and achieving greater health equity in the process.

About America’s Physician Groups

America’s Physician Groups is a national association representing more than 335 physician groups with approximately 170,000 physicians providing care to nearly 90 million patients. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based healthcare in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.

Written By: VillageMD