Lehigh Valley Health Network Accountable Care Organization, LLC: Medicare Shared Savings Program Performance Year 2016 Quality and Financial Results
The Centers for Medicare & Medicaid Services (CMS) announced the 2016 performance year results for the Medicare Shared Savings Program. Medicare Accountable Care Organizations are groups of doctors, hospitals, and other health care providers, who come together voluntarily to provide coordinated, high quality care to their Medicare patients.
The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO meets quality and financial thresholds – demonstrating achievement of high-quality care and wiser, more efficient spending of health care dollars – it is able to share in the savings generated for Medicare. An ACO may create savings for CMS, but if this minimum threshold is not achieved, the ACO does not receive any additional payment from the shared savings program. LVHN ACO performed in the top 20% for savings when compared to the other 26 ACOs with a presence in Pennsylvania.
In 2016, the Lehigh Valley Health Network (LVHN) Accountable Care Organization (ACO) provided high value and cost efficient care, achieving an outstanding quality score of ~98%. In addition to providing exceptional care, the LVHN ACO achieved a total savings of over $4.8 million dollars. Despite the savings, the minimum threshold was not achieved, which means that the LVHN ACO did not receive any of those savings back from CMS.
“The LVHN ACO recognizes the hard work that all of our physician and advanced practice clinician participants contribute to making this endeavor successful,” said Jennifer Stephens, DO, Medical Director of LVHN ACO. “We continue to be committed to high value, integrated healthcare that puts our patients first.”
Lehigh Valley Health Network includes eight hospital campuses - three in Allentown including the region's only facility dedicated to orthopedic surgery, one in Bethlehem, one in East Stroudsburg, one in Hazleton and two in Pottsville, Pa.; 26 health centers caring for communities in seven counties; numerous primary and specialty care physician practices and 18 ExpressCARE locations throughout the region including the area’s only Children’s ExpressCARE at the Health Center at Palmer Township; pharmacy, imaging, home health services and lab services; extensive inpatient and outpatient rehabilitation services; and preferred provider services through Valley Preferred. Specialty care includes: trauma care at the region’s busiest, most-experienced trauma center treating adults and children, burn care at the regional Burn Center, kidney and pancreas transplants; perinatal/neonatal, cardiac, cancer care, orthopedics, and neurology and complex neurosurgery capabilities including national certification as a Comprehensive Stroke Center. The Lehigh Valley Cancer Institute, the Lehigh Valley Heart Institute and the Lehigh Valley Institute for Special Surgery give clinicians of the highest caliber the necessary infrastructure, programs and partnerships to help community members stay healthy and provide the most advanced treatment when needed. The Lehigh Valley Cancer Institute is a formal member of the Memorial Sloan Kettering (MSK) Cancer Alliance, a transformative initiative to improve the quality of care and outcomes for people with cancer in community health care settings, including access to key MSK clinical trials. Robotic surgery is offered in ten specialties across the health network with more than 10,000 procedures performed since 2007. Lehigh Valley Children’s Hospital, the only children’s hospital and Level 4 NICU in the region, provides care in more than 30 specialties and general pediatrics. Lehigh Valley Hospital–Cedar Crest has been recognized among the top five hospitals in Pennsylvania by U.S. News & World Report for for five consecutive years. Lehigh Valley Hospital–Cedar Crest, Lehigh Valley Hospital–17th Street and Lehigh Valley Hospital–Muhlenberg are national Magnet hospitals for excellence in nursing. Additional information is available by visiting LVHN.org, or following us on Facebook and Twitter.