The Centers for Medicare & Medicaid Services (CMS) announced that the Southwestern Health Resources Accountable Care Network (SWHR ACN) saved almost $30 million in 2017, with an overall quality score of 100 percent for the fiscal year. These generated savings place it at the top of organizations participating in the CMS Next Generation Accountable Care Organization (ACO) Model.
The SWHR ACN is one of the 44 ACOs participating in the Next Generation ACO Model, which is Medicare’s highest-risk ACO model. These ACOs generated more than $208 million in gross savings, including discounts to Medicare, according to 2017 performance data made public from CMS. The SWHR ACN’s results represent more than 14 percent of total savings generated by all Next Generation ACOs.
The SWHR ACN manages care for nearly 69,000 Medicare beneficiaries in North Texas aligned through the Next Generation ACO Model. This is more than any other ACO in North Texas. With this Model, CMS sets predictable financial targets, enables providers and beneficiaries greater opportunities to coordinate care and aims to attain the highest-quality standards of care. In accordance with the Department of Health and Human Services, this accountable care model is evaluated on its ability to deliver better care for individuals, better health for populations and lower growth in expenditures.
“The delivery of tens of millions of dollars in savings while maintaining top-tier quality care for Medicare beneficiaries speaks to the thoughtful strategies our network has consistently initiated and widely embraced to improve efficiency in the delivery of care,” said Dr. Daniel K. Podolsky, president of UT Southwestern, who co-chairs Southwestern Health Resources with Barclay Berdan, FACHE, CEO of Texas Health Resources.
“These successful results reveal the advantages that a clinically integrated network of hospitals and doctors offers to patients and physicians,” said Mr. Berdan. “The strategies and insights developed with this population of Medicare beneficiaries help us deliver similar benefit to our broader Southwestern Health Resources network, multiplying the advantages of this valuable program far beyond the Medicare population.”
“Being ranked No. 1 in the nation for the most recent performance results further validates the success of the physician-driven strategies the SWHR ACN has designed to build a stronger system of care. While we’ve achieved significant savings, we also have focused on improving the quality of care delivered to patients to accomplish this,” said Dr. Mack Mitchell, chief medical officer, Southwestern Health Resources Physician Network.
The SWHR ACN has been among the country’s top-performing programs since 2015. It was approved in 2017 to participate in the Next Generation ACO Model.
Prior to this, the SWHR ACN achieved successful performance results as part of the CMS Medicare Shared Savings Program (MSSP), the national initiative to reduce costs by coordinating and delivering better health care for Medicare patients. This included delivering cumulative savings of $73 million during a three-year period (for 2014, 2015, and 2016), combined with maintaining a top-decile quality score in the 95th percentile nationally. SWHR ACN’s quality scores improved 5 percent among established measures and 13 percent on preventive measures.
The ACN includes UT Southwestern Medical Center faculty, Texas Health Physicians Group members, and independent community physicians. Formerly called the UT Southwestern Accountable Care Network (UTSACN), the organization was among the first to participate in the CMS MSSP.
“The results of Medicare ACOs are on the cutting edge, making the health care system more effective,” said Dr. Shawn Parsley, president and chief operating officer of Texas Health Physicians Group. “Our successful results reveal the advantages a clinically integrated network of hospitals and doctors offers to patients and physicians.”
Southwestern Health Resources, which was formed in 2016 by Texas Health Resources and UT Southwestern Medical Center, blends the strengths of both Texas Health and UT Southwestern from preventive care to the most advanced interventions to better serve North Texas residents. The integrated network builds on more than 50 years of collaboration between the two institutions to improve the health of North Texans. Southwestern Health is made up of a physician network, hospital network and a population health services company, which provides clinical and quality data along with analytic services necessary to support the physician-driven clinical decisions.
The Southwestern Health Resources network includes 29 hospital locations and more than 4,000 physicians. With more than 500 points of access to care, this provides for higher value and allows patients to access services across a full continuum of medical needs. The network serves people across 16 counties in North Texas. In total, Southwestern Health ACN coordinates care for more than 600,000 patients, aligned with commercial health care plans and Medicare programs.
For more information about the Southwestern Health Resources Next Generation ACO results (listed as UT Southwestern ACN), please go to CMS.gov, the Next Generation ACO Model landing pages.