Intermountain Healthcare’s Castell Helps Save Medicare $10 Million While Achieving a 98 Percent Score for Quality


The U.S. Centers for Medicare and Medicaid (CMS) recently announced the 2019 results for Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program. In just its second year in the program, Castell Accountable Care (previously Intermountain Accountable Care) received a quality score of 98.88 percent, placing it among the top 5 percent of ACOs nationally for quality. Simultaneously, the Castell ACO generated $10 million in savings for Medicare.

The savings amount is four times the amount Castell saved Medicare in 2018. Nationally, only 20 percent of ACOs that started in 2018 earned savings in both 2018 and 2019. Intermountain Medical Group was the sole participant in the Castell ACO during these years.

ACOs are groups of healthcare providers that voluntarily agree to be held accountable for the quality, cost, and experience of care for a population of fee-for-service Medicare beneficiaries. Reducing Medicare spending saves the government and taxpayers money. The Medicare Shared Savings Program provides incentives for healthcare providers to keep patients healthy, improve health quality and patient outcomes and lower costs. CMS evaluates how well each ACO meets these goals every year.

The Castell ACO generated savings for Medicare by keeping cost growth slower than the national average. This comes primarily through helping patients stay healthy to eliminate avoidable hospitalizations and smoothly transition home following a hospitalization. Performance on quality measures is a reflection of Intermountain’s low readmission rate, strong management of chronic conditions, and high patient experience ratings. Intermountain continued to improve on these measures in 2019, particularly in diabetes management and completion of falls risk assessments.

“Intermountain Healthcare has long been known for providing high quality care. Participation in the Medicare Shared Savings Program has helped us further elevate our quality while extending our impact to even more patients. This is just one example of how our innovative approach to practice transformation, data analytics, and quality improvement leads to better outcomes for patients, providers, and payers.” said Rajesh Shrestha, Castell president and CEO and Intermountain VP and COO for community-based care.

“Castell helps transform physician practices to not only make care more affordable for patients, but help patients achieve and maintain health for the long-term. Providers have increased access to primary care appointments, care coordinators support patients beyond the clinic, and nurse care managers help patients self-manage chronic health conditions. Castell has also deployed a post-acute care team to improve care when patients are discharged from the hospital,” said Josh Romney, MD, Castell’s medical director for both population health and the ACO.

“Care guides proactively reach out to patients who have gaps in their care and ensure patients see primary and specialty care providers early on, which helps them avoid urgent care, emergency room visits or acute hospital care later on. A big key to this, is development of our data tools to understand patient needs and provider performance in real-time, paired with resources to act on what we find in the data,” said Eric Cragun, Castell’s executive director for government programs and the administrator of the Castell ACO.

High performing ACOs receive a portion of any savings that result from reducing costs and meeting quality requirements, which helps support improvements in patient care. Per program guidelines, the ACO will receive $4.95 million of the savings, which will be used to reinvest in resources aligned with the ACO’s mission, such as creating additional data tools to improve quality and outcomes, providing primary care in the home, and forming better partnerships with specialists to ensure high-value specialty care.

Intermountain Healthcare is a not-for-profit system of 24 hospitals, 215 clinics, a Medical Group with 2,500 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Idaho, Utah, and Nevada. Intermountain is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs. For more information, see

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

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Holly Nelson