CHESS Accountable Care Organizations Save Medicare Millions Through Innovation

ACOs Improve Quality and Reduce Costs While Preserving Medicare Beneficiary Choice of Providers

CHESS Health Solutions’ physician-led Accountable Care Organizations (ACOs) saved Medicare $14.5 million in health care costs by meeting quality and cost goals in 2019, according to recently released performance data from the federal agency that administers Medicare.

These savings were obtained through the Centers for Medicare and Medicaid Services (CMS) Next Generation and Medicare Shared Savings Program (MSSP) Models.

CHESS NextGen, LLC ACO generated $9.39 million in savings through a quality score of 95.1 percent on performance measures ranging from preventive health checks to use of computerized health records to preventing avoidable hospitalizations, Medicare data show. This was the fourth performance year in the program. The ACO includes the providers from Catawba Valley Medical Group, Wake Forest Health Network and Wake Forest University Health Sciences.

In 2019, CHESS Value, LLC was comprised of health care providers from AdventHealth Hendersonville (Fletcher Hospital), Hugh Chatham Memorial Hospital, Carolina Ophthalmology, and Grace Hematology and Oncology. In that performance year, the ACO saved Medicare $5.1 million and achieved a quality score of 92.94 percent.

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide high-quality care to keep Medicare beneficiaries healthy through prevention, innovation, care coordination and information sharing.

“We continue to see data showing that collaboration and information sharing among care providers results in better outcomes,” says Yates Lennon, MD, president and chief transformation officer for CHESS Health Solutions. “These results are proof that when providers have access to greater information about each beneficiary, the beneficiaries receive better care at lower costs.”

For example, CHESS NextGen and CHESS Value ACO providers work to increase the number of Medicare beneficiaries taking advantage of annual wellness visits, including recommended screenings and preventive care. The ACO also focuses on ensuring smooth patient transitions from the hospital to home—or a skilled nursing facility if needed.

A market-based solution to fragmented and costly care, accountable care organizations empower local physicians, hospitals and other providers to work together and take responsibility for improving quality, enhancing patient experience and keeping care affordable. The Medicare Shared Savings Program (MSSP) and Next Generation ACO Model creates incentives for ACOs to invest in transformative care by allowing them to share in savings they generate after meeting defined quality and cost goals.