Park Nicollet Accountable Care Organization improves care, reduces Medicare costs by $1.9 million in 2019

The health system achieved its highest quality score since participating in the innovative federal program

MINNEAPOLIS, Minn. – In its fourth year of participating in the Next Generation Accountable Care Organization (ACO) Model with the Centers for Medicare and Medicaid Services (CMS), Park Nicollet’s efforts to improve cost, quality and patient experience resulted in its highest overall quality score and $1.9 million in Medicare savings.

The Park Nicollet ACO achieved an overall quality score of 95.81 percent on 23 quality and patient satisfaction measures in 2019, the highest score in its eight years of participating in a federal ACO model. The score is based on quality measures such as hospital readmissions, care for patients with chronic illnesses, patient experience and preventive care and screenings.

Park Nicollet implemented several initiatives to help meet or exceed the CMS measures, including the following areas of focus:

• Direct transfers to nursing homes. More than 100 patients avoided or shortened their stay at a hospital in 2019 and transferred directly to a nursing home or other skilled nursing facility without paying out of pocket. The Next Generation ACO Model allows Park Nicollet to waive a mandatory 3-day hospital stay before patients can be admitted to a skilled nursing facility for their care. The average cost for a hospital stay in Minnesota is an estimated $2,500 per day, compared to an estimated $250-$280 per day in a nursing home.
• Post-discharge home visits. A Next Generation ACO waiver allowed nurses to provide more comprehensive follow-up care for patients after a hospital discharge to help with the transition between hospital and home. During a home visit, the nurse reviews hospital instructions, warning signs and medication adherence with the patient to help prevent hospital readmissions, which average a cost of $11,000-$13,000.
• Improved care for patients with chronic conditions. Park Nicollet implemented a team-based model of care to develop care strategies and intensive case management that would better meet the needs of patients with Chronic Obstructive Pulmonary Disease (COPD) and End Stage Renal Disease (ESRD). Patients enrolled in COPD intensive case management did not come back to the hospital in 30 days, and team-based interventions for ESRD patients contributed to $298,000 in shared savings.

“Our results continue to be a positive reflection of the work we do to provide better care for our patients at a lower cost,” said Kristi Lyon, president of the Park Nicollet Next Generation ACO. “As one of the first participants in the Next Generation ACO Model, we have achieved savings for Medicare two out of the last four years, with our savings outweighing our losses. We have learned a lot through our ACO participation and are evaluating options to continue in these models that help us better serve our Medicare patients.”

Park Nicollet is the only health system in Minnesota and one of only 37 ACOs nationwide to participate in the Next Generation ACO Model. The Model, launched by CMS in 2016, allows health care providers to come together and provide coordinated, high-quality care at lower costs to patients. Organizations voluntarily participate, agreeing to share savings or losses with Medicare based on financial and quality performance.

More than 14,200 patients are part of the Park Nicollet Next Generation ACO, which was recognized by Becker’s Hospital Review as an ACO to Know in 2018 and 2019. The Next Generation ACO Model runs through 2021.