DALLAS, Texas – Baylor Scott & White Quality Alliance, Baylor Scott & White Health's accountable care organization (ACO), generated $96 million in savings in the Medicare Shared Savings Program (MSSP) in 2020. According to results released by the Centers for Medicare & Medicaid Services (CMS), the Quality Alliance generated the highest savings in the nation among ACOs who participated in the Pathways to Success downside risk model for the second year in a row.
The MSSP is an alternative payment model in which eligible healthcare providers, hospitals and suppliers are rewarded for achieving better health for individuals, improving population health and lowering healthcare costs. In 2020, the 513 participating ACOs saved Medicare $4.1 billion in gross savings and $2.8 billion in performance payments, resulting in improved care for 10.6 million seniors
BSWQA earned a net performance payment of $47.13 million that will be distributed to hospitals and physicians. About 92% of beneficiaries have been aligned with the ACO for two or more consecutive years, which shows patient retention with their primary care physician drives better value
Additionally, the organization continued to lead the industry in improving quality. In 2020, the Quality Alliance was able to expand and refine five quality measures from the previous year to increase efficiency, navigation, value and access
The National Association for Accountable Care Organizations said in a news release, "During the pandemic-stricken year of 2020, ACOs were valuable assets in managing patient care. Given their accountability to long-term patient care and outcomes, ACOs were proactive in their outreach to high-risk patients to keep them healthy, quickly established telehealth and remote monitoring capabilities to continue to provide care.
"For the third year in a row, we have delivered significant savings for Medicare, and in the midst of our response to the COVID-19 pandemic. Our 2020 results demonstrate that even when faced with an unforeseen and unprecedented health crisis, we remain committed to making healthcare better and more affordable through provider-led care coordination and design," said Jenny Reed, senior vice president of value-based care. "As the largest clinically integrated network in Texas, we were poised to meet this health crisis head on and demonstrated the ability to leverage our already established care model."
Within the MSSP population, the Quality Alliance saw notable improvements in performance, including increased primary care visits and a 17% increase in Care Management engagement which helped drive lower avoidable admissions and emergency department utilization despite the challenges posed by the pandemic.
Pandemic Bolstered the Case for Value-Based Health Care
Having refined its integrated care model with a focus on comprehensive care management, data analytics, and physician engagement, the Quality Alliance was poised to respond to the pandemic. The program was able to maintain the same level of preventative care despite the national trend of patients delaying care, which can result in sicker patients needing more expensive healthcare costs.
Through the health system's Safe Care efforts, the Quality Alliance was able to help patients navigate a "new world" in healthcare by offering more telehealth and remote offerings through the MyBSWHealth app to prevent delays in both preventive care and treatment, while also ensuring any in-person appointments were safe. In addition, the care management team helped scale the use of the MyBSWHealth app by giving increased access to caregivers.
"These increased digital offerings speak to our commitment to continually innovate and lower the cost of care while keeping quality at the forefront of everything we do," said Reed. "Our previous investment and work developing additional and more efficient ways to better serve our patients — including expanding hours and providing more convenient appointment types — paid off for providers in cost savings but also for our patients in the form more convenient access to quality care and improved health outcomes."
Contributing to these results were efforts to increase engagement and collaboration with providers by aligning the care management team with providers, embedding care managers in clinics, and educating providers about successful value-based care.
The Quality Alliance is the largest clinically integrated network in Texas. Since 2013, the Quality Alliance has refined its integrated care model, which encompasses comprehensive care management, data analytics, physician engagement and clinical excellence. Baylor Scott & White's experience delivering integrated care management, virtual health and an exceptional member experience began with its employees. The Quality Alliance now provides value-based care to over 750,000 lives, saving more than $200 million across 13 value-based contracts.
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About Baylor Scott & White Health
As the largest not-for-profit health system in the state of Texas, Baylor Scott & White promotes the health and well-being of every individual, family and community it serves. It is committed to making quality care more accessible, convenient and affordable through its integrated delivery network, which includes the Scott and White Health Plan (to be rebranded as Baylor Scott & White Health Plan in 2022), Baylor Scott & White Research Institute, the Baylor Scott & White Quality Alliance and its leading digital health platform – MyBSWHealth. Through 51 hospitals and more than 1,100 access points, including flagship academic medical centers in Dallas, Fort Worth and Temple, the system offers the full continuum of care, from primary to award-winning specialty care. Founded as a Christian ministry of healing more than a century ago, Baylor Scott & White today serves more than three million Texans. For more information, visit BSWHealth.com.