For the fifth consecutive year, NewYork Quality Care, the accountable care organization (ACO) of NewYork-Presbyterian, Columbia University Irving Medical Center and Weill Cornell Medicine, has earned shared savings in the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program. In 2021, NewYork Quality Care saved Medicare $26,335,014 while providing high quality care for more than 35,700 Medicare beneficiaries, according to performance results recently released by the CMS.
The three institutions will share $12,904,157 of the total savings generated by the program and reinvest the funds back into the ACO to further enhance the quality of care provided to Medicare patients. NewYork Quality Care achieved more savings for Medicare last year than any other New York Metropolitan area ACO that participated in the Medicare Shared Savings Program, according to the CMS data. In addition to the savings, NewYork Quality Care achieved a quality score of 91.4 percent in 2021. The quality score includes measures ranging from preventive screenings, like breast cancer and colorectal cancer screenings, to hospital readmissions.
“Throughout 2021 there were continued challenges with the COVID-19 pandemic for both patients and clinicians, and this achievement is due to the dedicated work of the physicians, nurses and care managers from NewYork-Presbyterian, Columbia University and Weill Cornell Medicine,” said Dr. Paul N. Casale, executive director of NewYork Quality Care. “As patients increasingly returned to in-person office visits, the clinicians worked closely with the ACO care management team to coordinate care, improve preventive services, reduce avoidable hospitalizations and emergency room visits, and successfully care for this population of patients."
The ACO data analysts began using electronic medical records and insurance claims data in 2021 to better identify the social factors that can affect a patient’s health -- such as transportation, food insecurity and housing -- known as social determinants of health. Using this information, NewYork Quality Care could proactively identify areas where a person might have gaps in their needs and reach out to connect them to resources. In addition, ACO data analysts identified patients who might have had difficulty obtaining COVID-19 vaccinations, and provided that information to the care managers who helped connect the patients to vaccine appointments.
NewYork Quality Care also used electronic medical records and remote patient monitoring to stay virtually connected to patients with complex medical needs. Care teams set up video or telephone appointments to oversee care coordination and medication management, and prioritized routine screenings by, for example, sending patients at-home test kits for colorectal cancer.
Accountable care organizations like NewYork Quality Care, which was established in 2015, are groups of doctors, hospitals and other health care providers that work together to provide Medicare beneficiaries high-quality, coordinated care while helping to reduce health care costs. These organizations can share in the savings they generate for Medicare if they meet specified savings and quality thresholds. This encourages ACOs to improve the coordination of health care for Medicare patients, particularly those with high-risk medical conditions, and to prioritize prevention and wellness.
NewYork Quality Care gives NewYork-Presbyterian, Columbia University Irving Medical Center and Weill Cornell Medicine an equal voice in the design and operations of the program, allowing for shared learning that helps everyone improve their performance. From 2017 to 2021, NewYork Quality Care has saved a total of $128,478,284 for CMS, earned a total of $59,422,709 in shared savings, and significantly improved the quality score from 82 percent in 2017 to 91.4 percent in 2021.
“We are proud that during a time when lives were disrupted and medical care became more challenging than ever, NewYork Quality Care lowered costs and, most importantly, delivered high-quality care to the Medicare beneficiaries we are privileged to serve,” Dr. Casale said.