Mercy Quality in Top Five Percent Among Accountable Care Organizations

September 22, 2015

By Mercy's Madelynn Innes

Mercy’s top leaders have spoken a lot lately about a “Triple Aim of Health Care” – that is, better health, better care and lower cost. Now, there’s proof to show they mean business.

Last month, the Centers for Medicare & Medicaid Services (CMS) published an annual assessment of the country’s Medicare Accountable Care Organizations. Based on CMS’ benchmarks assessing all ACOs’ efforts to save money while improving patients’ quality of care, the report shows that Mercy is well positioned to achieve its triple aim goal.  

“Mercy’s annual cost to treat each Medicare patient was 14.6 percent below the national average cost of a Medicare fee-for-service patient,” explained Dr. Jim Rogers, clinical vice president of Mercy Adult Primary Care.

This is Mercy’s second reporting year as one of the country’s 333 ACOs. This year’s report showed we’re 19 percent below the second year average cost for all ACOs. As a result of this reduction in costs, Mercy saved CMS $1.6 million in 2014. 

While generating financial savings, Mercy achieved a 93 percent quality performance rate on 33 quality measures. “We were in the top 5 percent in quality achievement of the pay-for-performance ACOs that reported quality data.” 

This is something we can all be proud to share with our patients who are Medicare beneficiaries, Dr. Rogers said. “Given the results of the CMS report, Mercy has shown we’re a low-cost provider for Medicare beneficiaries that is well positioned to achieve the triple aim of health care. This combination should also prove very attractive to employers as we seek to expand our direct contracting.”

Participation in an ACO is purely voluntary. Since we became one in 2013, some of the initiatives we’ve taken to collaborate care include:

  • Provide patient follow-up and support after hospital admissions to reduce hospital readmissions
  • Disease management programs for beneficiaries with chronic conditions
  • Reduce the need for Emergency department visits by providing same-day office appointments and Nurse on Call telephonic triage
  • Data support systems that reveal patient care needs and risk assessment.

“This is part of our effort to do the right thing for patients and taxpayers by providing the best care possible without spending unnecessary money,” Dr. Rogers explained. And since CMS tracks our performance and makes those results public, just as it did with the release of its report last month, he added, “patients can know how well we’re caring for them.”