Intermountain Healthcare’s Medicare Program Produces Savings for Taxpayers

Intermountain Healthcare’s Medicare Accountable Care Organization (ACO), a network of hospitals, physicians, and other healthcare providers who collaborate to improve the quality and experience of care for Medicare patients, saved the Medicare system $2.4 million in 2018, while maintaining top-tier quality of care, The Centers for Medicare and Medicaid Services announced.

This quality and cost performance comes at the end of Intermountain’s first year in the Medicare Shared Savings Program, a federal program focused on improving health and care. As a result, Intermountain will receive nearly $1.15 million, which will be used to re-invest in resources for improving care and shared with providers in the ACO.

Physicians and clinician teams participating in Intermountain’s ACO provide Medicare beneficiaries with safe, high quality, accessible, and affordable care – all within a patient-centered and patient-friendly experience.

Among the quality highlights for Intermountain’s ACO:

• Lower than average readmission rates across a range of populations, and a top decile overall readmission rate
• Above average performance in many preventive measures, including a depression screening rate of 88% compared to an average of 67% for all ACOs, and a pneumonia vaccination rate of 80% compared to an average of 76%

Medicare evaluates how well each ACO meets these goals every year. High performing ACOs receive a portion of any savings that result from reducing costs and meeting quality requirements, which may be used to invest in patient care or share a portion directly with participating providers.

Intermountain’s first-year performance is notable given that only about a fifth of new 2018 ACOs earned shared savings.

“Under the ACO model, Intermountain is developing industry-leading care models, access points, and coordination capabilities,” said Mikelle Moore, Intermountain’s ACO president and chief community health officer. “These efforts help patients stay healthier and can make healthcare more affordable. In addition, Intermountain’s efforts help reduce Medicare spending, saving the government and taxpayers money.”

Intermountain’s ACO started on January 1, 2018, immediately becoming the largest ACO program in Utah and one of the largest nationally. The program serves almost 50,000 Medicare beneficiaries across the state.

Intermountain and Castell – its new health platform company focused on value-based care – have taken major steps to build a successful model for population health.

In 2018, Intermountain launched its Reimagined Primary Care model designed to improve overall patient health through better access, care coordination, and resource allocation. The model has already seen notable results, such as 20 percent decrease in per member per month costs, 35 percent decrease in emergency department admissions, and 60 percent decrease in hospital admissions.

Intermountain is also advancing quality of care through better chronic disease management, refining care process models for specialty care, and working closely with post-acute partners to improve transitions of care.

Castell aims to scale Reimagined Primary Care and related population health efforts with new tools, analytics, and support so provider practices and others in the health industry can achieve similar success with value-based care.

“These results reflect the health of our community, Intermountain’s high-quality, low-cost model of care, and ongoing improvement efforts. The data confirms that Intermountain, even as a new ACO, is positioned both to help patients live the healthiest lives possible and to succeed under innovative payment models,” said Nick Bassett, vice president of Population Health Services for Castell.

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Castell is a comprehensive health platform company that makes the move to value-based care simple for providers, payers, health systems, and accountable care organizations. Castell delivers impactful analytic and service solutions designed to accelerate organizations’ transition from volume to value, improve outcomes, and keep costs more affordable. Castell is an Intermountain Healthcare company. For more information, visit CastellHealth.com.

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