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Nine ACOs Led by Primary Care Physicians Generated $27 Million in Shared Savings in Medicare Shared Savings Program

Second year results demonstrate improvement in health care quality and savings

WHITE PLAINS, N.Y.--(BUSINESS WIRE)--Aug. 26, 2015-- Collaborative Health Systems (CHS), a Universal American company (NYSE:UAM), announced today that nine Accountable Care Organizations (ACOs) that it formed in partnership with primary care physicians earned $27 million in shared savings as part of the Medicare Shared Savings Program (MSSP) for program year 2014. The number of ACOs that qualified for shared savings tripled compared to last year.

CHS has partnered with primary care physicians to operate 23 ACOs in 2014, the most of any organization in the Medicare Shared Savings Program. These ACOs include over 4,300 participating physicians serving more than 270,000 Medicare Fee-for-Service beneficiaries.

For these 23 ACOs, the results showed that:

  • 9 ACOs, serving more than 105,000 Medicare beneficiaries, including our flagship ACO in Houston, qualified for shared savings totaling $27 million. This compares to $20 million in shared savings paid to ACOs for the first program year 2012/13, which was longer.
  • 8 additional ACOs achieved savings but did not exceed the Minimum Savings Rate (MSR). Of those eight, four missed the MSR by less than 1%.
  • These 17 ACOs generated $80 million in total savings for The Centers for Medicare & Medicaid Services (CMS).
  • Quality scores improved for all ACOs, which indicates improved healthcare management particularly for our chronically ill beneficiaries. For example, hospitalizations in 2014 decreased on average by 11% for beneficiaries with chronic obstructive pulmonary disease (COPD) and by 8% for beneficiaries with congestive heart failure (CHF). For beneficiaries with type 1 or type 2 diabetes, the quality score measuring hemoglobin levels – an indication that blood sugar levels are under control - improved 10%.

Richard A. Barasch, CEO of Universal American, commented. “The 2014 results reflect the impressive efforts of our physician partners as they move to a system in which they will be appropriately rewarded for positively impacting the quality and cost of healthcare for their patients. We are pleased to play an integral role in their transformation to a value-based payment system by providing actionable data and other tools to deliver real time care coordination and closure of gaps in care. This is hard work but our physician partners are getting increasingly comfortable with these activities and we now have tangible proof of the positive impact they are bringing to the quality of care and healthcare costs for Medicare beneficiaries. We are also encouraged by the commitment shown by CMS to the Medicare ACO program in the final rule for 2016 and beyond. We are excited by our progress and remain committed to the MSSP program.”

Jeffery Spight, President of Collaborative Health Systems, noted the company’s performance across the wide range of experience and healthcare settings of its partners. “This year’s results demonstrate the impact of the ACO model. From our most experienced physician partners in Houston, to our newest partners in the Washington, D.C. metropolitan area, to our partners delivering care in underserved areas of the country through Federally Qualified Health Centers (FQHCs), we are delighted that practices in different regions of the country caring for diverse patient populations generated significant savings and better quality of care.”

About Collaborative Health Systems

Collaborative Health Systems (CHS), a Universal American company (NYSE: UAM), is a management services organization that partners with primary care physicians as they move to value-based payment delivery. Our core belief at CHS is that primary care physicians are in the best position to coordinate care for their patients in the value-based environment. CHS provides comprehensive support for its physician partners by providing actionable data to help coordinate care and helping practices change behavior to meet the new quality requirements of the value-based payment system. CHS currently manages 25 MSSP ACOs, with more than 4,200 providers, mostly primary care physicians, covering more than 290,000 Medicare beneficiaries. For more information, visit http://www.CollaborativeHealthSystems.com.

About Universal American Corp.

Universal American (NYSE:UAM), through our family of healthcare companies, provides health benefits to people covered by Medicare and/or Medicaid. We are dedicated to working collaboratively with healthcare professionals, especially primary care physicians, in order to improve the health and well-being of those we serve and reduce healthcare costs. For more information on Universal American, please visit our website at www.UniversalAmerican.com.

Source: Universal American Corp.

Collaborative Health Systems
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