The
health system was the only accountable care organization in Texas to land a
spot in the top 10 for Medicare savings nationwide.
By Dom DiFurio 5:45 PM on Oct 7, 2019
Baylor Scott &
White's accountable care organization created $39.3 million in savings last
year for the federal government's Medicare Shared Savings Program, the highest total
among participating Texas hospitals.
Baylor Scott &
White's results also placed the health system seventh nationally,
earning it $18.7 million in shared savings, according to results released
this week by the Centers for Medicare & Medicaid Services.
It's is one
of 548 total MSSP participants in the country working to provide
higher quality care at a lower cost through accountable care organizations.
Participants that demonstrate improved health care conditions are
rewarded with a share of the savings. Nationally, ACOs saved Medicare $1.7
billion last year.
"Baylor Scott
White Quality Alliance is really a huge investment ... to change the way health
care is delivered and make it more affordable and better for the communities
that we serve," said Jenny Reed, vice president of comprehensive care
management at Baylor Scott & White.
ACOs, like Baylor
Scott & White Quality Alliance, were created as an alternative payment
model with the intention of improving quality and cost accountability for
patients using Medicare. ACOs are an umbrella of physicians and hospitals,
which work with health insurers to lower health care costs.
"We're not
taking our foot off the gas," Reed said.
Baylor Scott &
White credits its improvements in 2018 to comprehensive care management,
use of data analytics and physician engagement.
Last year, the
ACO was able to implement resources it hadn't in previous years like
additional staffing, which included nurses, community health workers and social
workers. And it plans to add even more this year, said Clifford Fullerton,
president of the quality alliance.
Baylor Scott &
White reported improvements in hospital readmissions, avoidable hospital
admissions, and Medicare annual wellness visits in 2018. Hospital
readmissions fell from 12.55% in 2017 to 12.36% in 2018, according to the
ACO. Avoidable hospital admissions per 1,000 beneficiaries also decreased
by 9.2% in 2018.
Rather than letting a
person who has a chronic illness go to the emergency room for unplanned care,
the ACO works with physicians to improve care and efficiency through phone
calls or office visits, ideally preventing conditions from worsening to the
point of an ER visit, Reed said.
With about 125,000
beneficiaries, Baylor Scott & White's program saved an estimated $314
per beneficiary in 2018.
Early studies have shown varying degrees of success
from the Medicare savings program in its relatively short existence. Baylor
Scott & White said its continued improvement is a demonstration that the
model can change the way health care is structured for the better.
"I think we're
beginning to see the proof that it can work and start to drive down costs
without just creating some sort of a draconian way of avoiding care,"
Fullerton said.
Baylor Scott
& White is Texas' largest nonprofit health system, with 50 hospitals.
https://www.dallasnews.com/business/2019/10/07/baylor-scott-whites-quality-alliance-led-texas-medicare-savings/
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