Trinity Health Accountable Care Organization Achieves $15.9 Million in Shared Savings for 2021, Saving Medicare More Than $20 Million

Trinity Health Accountable Care Organization (ACO), a Next Generation ACO, achieved $15.9 million in shared savings in performance year 2021 – saving Medicare more than $20 million and nearly $170 million since the program’s inception.

“Trinity Health ACO is proud of our cost savings over the past six years,” said Emily Brower, senior vice president of clinical integration and physician services for Trinity Health. “Our focus on being good stewards of quality and the Medicare dollar, in addition to the dedication of our providers in service to their patients, has allowed us to save Medicare nearly $170 million since the start of the model six years ago. This savings, in addition to our high-quality score of over 94% in every year of performance, showcases the value the model provides to more than 73,000 Medicare beneficiaries and communities across the country.”

The Next Generation ACO Model was created by the Centers for Medicare & Medicaid Services (CMS) to set predictable financial targets, gave beneficiaries more opportunities to manage their own health, and enabled providers to better coordinate care across health systems. The five-year model was extended by CMS through 2021 due to the COVID-19 pandemic. Although the model has ended, this important work continues as the Trinity Health Clinically Integrated Networks (CINs) in this model joined the Trinity Health Integrated Care ACO, a Medicare Shared Savings Program Enhanced track ACO, starting January 2022.

Next Generation ACOs, like Trinity Health ACO, are patient-centered organizations that take a higher degree of accountability for total cost of care and patient outcomes. In terms of participation, they can select individual providers who have demonstrated an elevated level of engagement and coordination and provide flexibility for the ACO to contract directly with other providers who are important to achieving optimal clinical and financial outcomes. Next Generation ACOs also offer a small pre-payment to help fund the ACO or practice infrastructure. Trinity Health values these features and has proposed they be included in a full-risk track for the Medicare Shared Savings Program ACO Model.

Trinity Health’s participation in Medicare ACOs is through more than 15,000 physicians and advanced practice professionals, committed to 16 CINs that are accountable for approximately 1.5 million lives across the country through alternative payment models (APMs) across all populations and product lines: Medicaid, Commercial, Medicare Advantage, and Medicare ACOs. The CINs that participated in Trinity Health ACO coordinate care for patients in Illinois (Loyola Physician Partners, part of Loyola Medicine), Michigan (Trinity Health Alliance of Michigan), New Jersey (Summit Health) and Ohio (Mount Carmel Health Partners, part of Mount Carmel Health System).

Ashish Parikh, MD, chief quality officer for Summit Health, said, “Summit Health was proud to partner with our colleagues in the Trinity Health ACO to deliver great care to our patients at a lower cost. Over the past six years, the members of the ACO shared knowledge and collaborated on initiatives for continual improvement in health outcomes. Summit Health has implemented the shared learnings from Trinity Health ACO to drive ever-better care across our entire patient population.”

Through Trinity Health’s ACO, patients experience no change in their original Medicare benefits and retain their freedom to see any Medicare provider. In order to share the savings it achieves for the Medicare initiative, Trinity Health ACO is required to succeed in both delivering high-quality care and spending health care dollars wisely.

“The Next Generation ACO program has allowed us to be on the cutting edge of health care delivery transformation” said Shaun Raleigh, VP of Population Health Management, Trinity Health Michigan. “The success in this program has not only lowered costs and bettered outcomes for the patients we manage under the ACO, but it has also spread across our entire patient population through the engagement of our devoted caregivers, making our population as a whole happier and healthier.”

For more information on the Next Generation ACO Model, please visit www.medicare.gov. For more information on Trinity Health ACO, visit www.trinityhealthaco.org.