CHESS ACOs Transform Patient Lives While Saving Millions for Medicare

Wooden letters stacked on coins to represent MSSP Savings

Accountable Care Organizations Touch Patient Lives in Ways That Keep Them Healthier.

CHESS Health Solutions’ physician-led Accountable Care Organizations (ACOs) saved Medicare $7 million in health care costs by meeting savings goals in 2022, according to recently released performance data from CMS, the federal agency that administers Medicare. These results were achieved by CHESS Value & CHESS Innovation ACOs through the Centers for Medicare and Medicaid Services Medicare Shared Savings Program.

More importantly, these ACOs directly impacted patient lives, such as that of Gloria, a 72-year-old retired widow with a heat condition, diabetes, and depression. Her barrier to care was no transportation from her rural community to a larger town for regular healthcare services to keep her conditions under control. CHESS ACOs were able to get her transportation resources and meals delivered to her home.

There is also Simon, a patient who lost his Medicare Part D coverage and was unable to afford the medication he needed. CHESS ACOs helped him obtain alternative medication coverage so that he could continue his medication until he was able to re-enroll in the Part D program. Both patients received early interventions and avoided costly unnecessary care. These are two examples of how accountable care organizations save money and improve patient outcomes.

In 2022, CHESS Value, LLC ACO was comprised of health care providers from AdventHealth Hendersonville (Fletcher Hospital), Hugh Chatham Memorial Hospital, Northern Hospital of Surry County, Charles A. Cannon, Jr Memorial Hospital, Appalachian Regional Medical Associates, Inc., Watauga Medical Center, and Kintegra Health (Gaston Family Health Services). In that performance year, the CHESS Value ACO saved Medicare $5.52 million and achieved a quality score of 82 percent.

CHESS Innovation, LLC ACO generated $1.57 million in savings through a quality score of 90.16 percent on performance measures ranging from preventive health checks to use of computerized health records to preventing avoidable hospitalizations. This ACO includes the providers from Wake Forest University Health Sciences, Wake Forest Health Network, and Catawba Valley Medical Group.

“Our data continues to inform us that by working together and sharing information among themselves, care providers have better outcomes,” says Yates Lennon, MD, president for CHESS Health Solutions. “These results are proof that when providers have better insights about each beneficiary, as well as the resources to tackle non-clinical barriers to care, the beneficiaries receive better care at lower costs.”

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. A successful ACO effectively balances the triple aim of healthcare: improving patient experience, improving population health, and reducing costs. It does so by fostering collaboration, utilizing data-driven insights, and continuously refining its strategies to provide the best possible care for its patient population.