Park Nicollet Accountable Care Organization reduces Medicare costs by $4.5 million in 2017

MINNEAPOLIS – The Centers for Medicaid and Medicare Services (CMS) reported that the Park Nicollet Next Generation Accountable Care Organization (ACO) met stringent goals for quality, efficiency and patient satisfaction in 2017. The Park Nicollet ACO cares for approximately 12,600 patients and achieved a quality score of 93 percent.

An ACO is a group of doctors, hospitals and other health care providers who give coordinated, high quality care to patients. Park Nicollet is one of 51 participants in the Next Generation ACO Model nationwide and the only one in Minnesota.

30 measures for cost and quality

The score is based on quality measures such as preventing hospital readmissions, coordinating care for patients with chronic illnesses, care for mental health, patient experience and providing preventive care. Meeting quality measures improved care and lowered medical costs by $4.5 million in 2017. Here are some ways Park Nicollet achieved this:

Coordinated care for kidney disease. Providers and registered nurse care consultants coordinated care for about 100 patients with advanced kidney disease. The care team includes pharmacists who provide medication therapy management. This coordination improved care and reduced costs by $600,000 in one year. Care Coordination activities are also provided for all patients that need support regardless of condition or payer.

Direct admissions to nursing homes. Patients who were cared for by physicians in the Next Generation ACO had fewer days than expected in the hospital. This was made possible through a waiver that allows ACOs to admit eligible patients to a nursing home or other skilled nursing facility instead of requiring them to first stay in a hospital for three days. The average in Minnesota for a hospital stay is an estimated $2,300 per day. This compares to an estimated $250-$300 per day in a nursing home.

Primary care. Eligible Medicare patients are encouraged to get an annual wellness visit. This ensures that patients receive recommended preventive care and it enables the primary care team to coordinate care and help the patient get needed care in the appropriate setting.

“Park Nicollet is committed to providing high quality care at low cost to our all of our patients,” John Misa, Sr. Director of Primary Care said. ACO participants that provide high quality, cost efficient care and meet goals around patient experience can share in any savings with Medicare. Organizations must reimburse CMS if they do not meet targets. CMS reported that in its first year (2016), the Next Generation ACO Model reduced costs by approximately $62 million. Park Nicollet was also named a 2018 ACO to know ACO by Becker Hospital Review.