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MSSP ACO Results Performance Period 1

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WayPoint Healthcare Advisors
WayPoint Healthcare Advisors

Source: CMS - Performance Year 1 quality performance results for ACOs with 2012 and 2013 agreement start dates

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MSSP ACO Performance Period 1 Final Summary September 29, 2014
Shared Savings Performance Years ACO Start Date Performance Year 1 Reporting Period 1 Performance Year 1 Reporting Period 2 Performance Year 2 Reporting Period 3 Performance Year 3 Reporting Period 4 Shared Savings ProgramACOs (April 2012 start) April 1, 2012 to December 31, 2013 January 1, 2012 to December 31, 2012 April 1, 2012 to December 31,2013 January 1, 2013 to December 31,2013 January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Shared Savings ProgramACOs (July 2012 start) July 1, 2012 to December 31, 2013 January 1, 2012 to December 31,2012 July 1, 2012 to December 31, 2013 January 1, 2013 to December 31, 2013 January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Shared Savings ProgramACOs (January 2013 start) NA January 1, 2013 to December 31, 2013 Same January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Pay for Reporting / Pay for Performance Pay for Reporting Pay for Reporting Pay for Performance Phase-in Pay for Performance phase-in
Winners and Losers Generated Savings Count of ACOs And the implications are…. $0 150 Received no shared savings payment. May still be responsible for Advance Payment repayment. Losses 1 Responsible for loss repayment and Advance Payment repayment. Savings 53 / 49 All received shared savings payment except 4 which did not meet the quality reporting requirements. TBD 16 To be determined… Total 220
Winners by State ACOs by State ACOs Earning Savings Shared Savings Payments* TX 7 $62.87 FL 11 $50.83 NY 3 $28.06 MI 2 $20.66 CA 4 $17.30 NJ 2 $15.64 VA, TN 2 $13.61 MA, NH 2 $11.91 NC 1 $10.54 GA 1 $9.74 WI 1 $8.67 MA 2 $7.46 ACOs by State ACOs Earning Savings Shared Savings Payments* MA 2 $7.46 OH 1 $5.78 NJ, NY 1 $5.27 IA, PA, CT, MA, CA 1 $5.16 MO, KS 1 $5.01 TN, LA, FL 1 $4.72 IA 1 $4.43 MA, RI 1 $3.56 KY, IL 1 $2.81 KY 1 $2.76 VA 1 $2.33 NV 1 $1.64 Total 49 $300.76 * In millions
The Winners by ACO # ACOs with Savings and Payments Shared Savings Payments* Percent of Total Cumulative Percent of Total 1 Memorial Hermann Accountable Care Organization $28.34 9% 9% 2 Palm Beach Accountable Care Organization, LLC $19.34 6% 16% 3 Catholic Medical Partners-Accountable Care IPA, Inc. $13.68 5% 20% 4 Southeast Michigan Accountable Care, Inc. $12.09 4% 24% 5 RGV ACO Health Providers, LLC $11.90 4% 28% 6 ProHEALTH Accountable Care Medical Group, PLLC $10.74 4% 32% 7 Triad Healthcare Network, LLC $10.54 4% 35% 8 WellStar Health Network, LLC $9.74 3% 39% 9 Accountable Care Coalition of Texas, Inc. $9.36 3% 42% 10 Accountable Care Coalition of Southeast Wisconsin, LLC $8.67 3% 45% Grand Total 49 $300.76 * In millions
By Start Date #ACOs by Start Date Shared Savings Payments / Losses* 4/1/2012 27 $64.00 7/1/2012 87 $165.77 1/1/2013 106 $67.03 Total 220 $296.80 * In millions # ACOs by Start Date Shared Savings Payments* 4/1/2012 8 $64.00 7/1/2012 22 $169.73 1/1/2013 19 $67.03 Total 49 $300.76 * In millions
Track 1 vs Track 2 # ACOs by Track Shared Savings Payments / Losses* Track 1 215 $283.85 Track 2 5 $12.95 Total 220 $296.80 * In millions # ACOs by Track Shared Savings Payments* Track 1 47 $283.85 Track 2 2 $16.91 Total 49 $300.76 * In millions
Track 1 vs Track 2 # ACOs by Track Shared Savings Payments / Losses* Track1 215 $283.85 Track2 5 $12.95 Grand Total 220 $296.80 Only 5 Track 2 ACOs Savings / Losses Shared Savings Payments / Losses Dean Clinic and St. Mary's Hospital ACO (WI) ($9.97) ($3.96) Physicians of Cape Cod ACO (MA) $0.00 $0.00 Accountable Care Coalition of DeKalb. (GA) $0.00 $0.00 Heartland Regional Medical Center (MO/KS) $8.53 $5.01 RGV ACO Health Providers* (TX) $20.24 $11.90 *Participate in Advance Payment Model
Advance Payment ACOs # Advance Payment ACOs Shared Savings Payments / Losses* No 184 $266.13 Yes 36 $30.67 Total 220 $296.80 * In millions # Advance Payment ACOs Shared Savings Payments * No 41 $270.09 Yes 8 $30.67 Total 49 $300.76 * In millions
Advance Payment ACOs # Advance Payment ACOs Shared Savings Payments / Losses No 184 $266.13 Yes 36 $30.67 Grand Total 220 $296.80 11 Advance Payment ACOs with Savings or TBD Savings / Losses RGV ACO Health Providers-TX $20.24 Physicians ACO-TX $12.01 Coastal Medical-MA, RI $7.27 National ACO-CA $6.19 Rio Grande Valley Health Alliance-TX $6.01 Jackson Purchase Medical Associates, PSC-KY, IL $5.74 Reliance Health Network-FL $4.96 Bay Area Florida Physicians Trust-FL $4.56 Integrated ACO LLC-TX $3.57 Medical Mall Services of Mississippi-MS, AL TBD North Country ACO-NH, VT TBD
Advance Payment ACOs with No Savings 25 Advance Payment ACOs with No Savings NOMS ACO-OH Texoma ACO-TX Primary Partners-FL Fort Smith Physicians Alliance ACO-AR, OK Coastal Carolina Quality Care-NC ACO Health Partners-FL Golden Life Healthcare-CA American Health Alliance-FL MPS ACO Physicians-CT Nature Coasts ACO-FL PriMed-CT Physicians Collaborative Trust ACO-FL Accountable Care Partners-FL Primary Partners ACIP-FL Quality Independent Physicians-KY, IN Owensboro ACO-KY, IN Harbor Medical Associates-MA KCMPA-ACO-MO, KS Maryland ACO Eastern Shore-MD SERPA ACO-NE Maryland ACO Western MD-MD, PA, WV American Hlth Network of Ohio Care Org, OH Cumberland Ctr for Healthcare Innovation-TN Lower Shore ACO-VA, MD, DE St. Thomas Medical Group-TN
Quality Reporting # ACOs Reporting Quality Shared Savings Payments / Losses* No 11 $0.00 Yes 209 $296.80 Total 220 $296.80 * In millions # ACOs Reporting Quality Shared Savings Payments* No 0 $0.00 Yes 49 $300.76 Grand Total 49 $300.76 * In millions
Quality Reporting # ACOs Reporting Quality Shared Savings Payments / Losses No 11 $0.00 Yes 209 $296.80 Grand Total 220 $296.80 11 ACOs Not Meeting Quality Reporting Requirement Savings / Losses Nevada Primary Care Network, ACO-NV $21.69 Physicians ACO-TX $12.01 Independent San Diego ACO-CA $7.96 Morehouse Choice ACO and Education System-GA $1.92 Florida Physicians Trust-FL $0.00 Accountable Healthcare Alliance-MI $0.00 Meridian Holdings-NC, GA, FL, SC, DC, CA, MD, TX $0.00 Accountable Care Organization of Puerto Rico-PR $0.00 NOMS ACO-OH $0.00 Allcare Options-FL TBD Medical Mall Services of Mississippi-MS, AL TBD

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MSSP ACO Results Performance Period 1

  • 1. MSSP ACO Performance Period 1 Final Summary September 29, 2014
  • 2. Shared Savings Performance Years ACO Start Date Performance Year 1 Reporting Period 1 Performance Year 1 Reporting Period 2 Performance Year 2 Reporting Period 3 Performance Year 3 Reporting Period 4 Shared Savings ProgramACOs (April 2012 start) April 1, 2012 to December 31, 2013 January 1, 2012 to December 31, 2012 April 1, 2012 to December 31,2013 January 1, 2013 to December 31,2013 January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Shared Savings ProgramACOs (July 2012 start) July 1, 2012 to December 31, 2013 January 1, 2012 to December 31,2012 July 1, 2012 to December 31, 2013 January 1, 2013 to December 31, 2013 January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Shared Savings ProgramACOs (January 2013 start) NA January 1, 2013 to December 31, 2013 Same January 1, 2014 to December 31, 2014 Same January 1, 2015 to December 31, 2015 Same Pay for Reporting / Pay for Performance Pay for Reporting Pay for Reporting Pay for Performance Phase-in Pay for Performance phase-in
  • 3. Winners and Losers Generated Savings Count of ACOs And the implications are…. $0 150 Received no shared savings payment. May still be responsible for Advance Payment repayment. Losses 1 Responsible for loss repayment and Advance Payment repayment. Savings 53 / 49 All received shared savings payment except 4 which did not meet the quality reporting requirements. TBD 16 To be determined… Total 220
  • 4. Winners by State ACOs by State ACOs Earning Savings Shared Savings Payments* TX 7 $62.87 FL 11 $50.83 NY 3 $28.06 MI 2 $20.66 CA 4 $17.30 NJ 2 $15.64 VA, TN 2 $13.61 MA, NH 2 $11.91 NC 1 $10.54 GA 1 $9.74 WI 1 $8.67 MA 2 $7.46 ACOs by State ACOs Earning Savings Shared Savings Payments* MA 2 $7.46 OH 1 $5.78 NJ, NY 1 $5.27 IA, PA, CT, MA, CA 1 $5.16 MO, KS 1 $5.01 TN, LA, FL 1 $4.72 IA 1 $4.43 MA, RI 1 $3.56 KY, IL 1 $2.81 KY 1 $2.76 VA 1 $2.33 NV 1 $1.64 Total 49 $300.76 * In millions
  • 5. The Winners by ACO # ACOs with Savings and Payments Shared Savings Payments* Percent of Total Cumulative Percent of Total 1 Memorial Hermann Accountable Care Organization $28.34 9% 9% 2 Palm Beach Accountable Care Organization, LLC $19.34 6% 16% 3 Catholic Medical Partners-Accountable Care IPA, Inc. $13.68 5% 20% 4 Southeast Michigan Accountable Care, Inc. $12.09 4% 24% 5 RGV ACO Health Providers, LLC $11.90 4% 28% 6 ProHEALTH Accountable Care Medical Group, PLLC $10.74 4% 32% 7 Triad Healthcare Network, LLC $10.54 4% 35% 8 WellStar Health Network, LLC $9.74 3% 39% 9 Accountable Care Coalition of Texas, Inc. $9.36 3% 42% 10 Accountable Care Coalition of Southeast Wisconsin, LLC $8.67 3% 45% Grand Total 49 $300.76 * In millions
  • 6. By Start Date #ACOs by Start Date Shared Savings Payments / Losses* 4/1/2012 27 $64.00 7/1/2012 87 $165.77 1/1/2013 106 $67.03 Total 220 $296.80 * In millions # ACOs by Start Date Shared Savings Payments* 4/1/2012 8 $64.00 7/1/2012 22 $169.73 1/1/2013 19 $67.03 Total 49 $300.76 * In millions
  • 7. Track 1 vs Track 2 # ACOs by Track Shared Savings Payments / Losses* Track 1 215 $283.85 Track 2 5 $12.95 Total 220 $296.80 * In millions # ACOs by Track Shared Savings Payments* Track 1 47 $283.85 Track 2 2 $16.91 Total 49 $300.76 * In millions
  • 8. Track 1 vs Track 2 # ACOs by Track Shared Savings Payments / Losses* Track1 215 $283.85 Track2 5 $12.95 Grand Total 220 $296.80 Only 5 Track 2 ACOs Savings / Losses Shared Savings Payments / Losses Dean Clinic and St. Mary's Hospital ACO (WI) ($9.97) ($3.96) Physicians of Cape Cod ACO (MA) $0.00 $0.00 Accountable Care Coalition of DeKalb. (GA) $0.00 $0.00 Heartland Regional Medical Center (MO/KS) $8.53 $5.01 RGV ACO Health Providers* (TX) $20.24 $11.90 *Participate in Advance Payment Model
  • 9. Advance Payment ACOs # Advance Payment ACOs Shared Savings Payments / Losses* No 184 $266.13 Yes 36 $30.67 Total 220 $296.80 * In millions # Advance Payment ACOs Shared Savings Payments * No 41 $270.09 Yes 8 $30.67 Total 49 $300.76 * In millions
  • 10. Advance Payment ACOs # Advance Payment ACOs Shared Savings Payments / Losses No 184 $266.13 Yes 36 $30.67 Grand Total 220 $296.80 11 Advance Payment ACOs with Savings or TBD Savings / Losses RGV ACO Health Providers-TX $20.24 Physicians ACO-TX $12.01 Coastal Medical-MA, RI $7.27 National ACO-CA $6.19 Rio Grande Valley Health Alliance-TX $6.01 Jackson Purchase Medical Associates, PSC-KY, IL $5.74 Reliance Health Network-FL $4.96 Bay Area Florida Physicians Trust-FL $4.56 Integrated ACO LLC-TX $3.57 Medical Mall Services of Mississippi-MS, AL TBD North Country ACO-NH, VT TBD
  • 11. Advance Payment ACOs with No Savings 25 Advance Payment ACOs with No Savings NOMS ACO-OH Texoma ACO-TX Primary Partners-FL Fort Smith Physicians Alliance ACO-AR, OK Coastal Carolina Quality Care-NC ACO Health Partners-FL Golden Life Healthcare-CA American Health Alliance-FL MPS ACO Physicians-CT Nature Coasts ACO-FL PriMed-CT Physicians Collaborative Trust ACO-FL Accountable Care Partners-FL Primary Partners ACIP-FL Quality Independent Physicians-KY, IN Owensboro ACO-KY, IN Harbor Medical Associates-MA KCMPA-ACO-MO, KS Maryland ACO Eastern Shore-MD SERPA ACO-NE Maryland ACO Western MD-MD, PA, WV American Hlth Network of Ohio Care Org, OH Cumberland Ctr for Healthcare Innovation-TN Lower Shore ACO-VA, MD, DE St. Thomas Medical Group-TN
  • 12. Quality Reporting # ACOs Reporting Quality Shared Savings Payments / Losses* No 11 $0.00 Yes 209 $296.80 Total 220 $296.80 * In millions # ACOs Reporting Quality Shared Savings Payments* No 0 $0.00 Yes 49 $300.76 Grand Total 49 $300.76 * In millions
  • 13. Quality Reporting # ACOs Reporting Quality Shared Savings Payments / Losses No 11 $0.00 Yes 209 $296.80 Grand Total 220 $296.80 11 ACOs Not Meeting Quality Reporting Requirement Savings / Losses Nevada Primary Care Network, ACO-NV $21.69 Physicians ACO-TX $12.01 Independent San Diego ACO-CA $7.96 Morehouse Choice ACO and Education System-GA $1.92 Florida Physicians Trust-FL $0.00 Accountable Healthcare Alliance-MI $0.00 Meridian Holdings-NC, GA, FL, SC, DC, CA, MD, TX $0.00 Accountable Care Organization of Puerto Rico-PR $0.00 NOMS ACO-OH $0.00 Allcare Options-FL TBD Medical Mall Services of Mississippi-MS, AL TBD