October 12, 2023
Denver, Colorado — Community Health Provider Alliance (CHPA) improved care for 13,844 Medicare beneficiaries in Colorado and saved Medicare $15,270,028 by meeting quality and cost goals in 2022, according to recently released performance data from the federal agency that administers Medicare, Centers for Medicare & Medicaid Services (CMS).
Medicare data shows CHPA earned a quality score of 70.63% on performance measures ranging from preventive health checks to use of computerized health records to preventing avoidable hospitalizations. The $15,270,028 of gross savings to Medicare resulted in a shared savings payment of $7,482,314 to CHPA, 48% of which will be distributed directly to the participating member Federally Qualified Health Centers (FQHCs), also known as Community Health Centers (CHCs). An additional 20% will be distributed to CHCs at the discretion of the Board to drive quality improvement. CHPA will use 21% to support improvement efforts at individual CHCs, 6% will be awarded to CHCs through a Member Development fund, and the remaining 5% will be used to support CHPA’s operating costs.
CHPA joined the CMS MSSP in 2017 and shared savings were first earned in the third performance year of 2019. CHPA has continued achieving savings since then, providing $52 million in total savings for CMS over the last four years. CHPA continues to implement various programs to reduce the total cost of care while improving quality and patient satisfaction.
Member CHCs who participated in the MSSP program work to increase the number of Medicare beneficiaries utilizing annual wellness visits, including recommended screenings and preventive care. The accountable care organization (ACO) also focuses on ensuring smooth patient transitions from the hospital to home and provides various supports to manage patients with chronic conditions and complex social risk factors. All member CHCs receive detailed information about their performance on quality measures from CHPA. Additionally, clinicians and providers share best practices to coordinate the care beneficiaries receive from different primary care and specialty providers to prevent health issues and repeat hospitalizations.
CHPA’s 18 participating member CHCs have independent electronic health records (EHRs) and in addition to achieving savings in the 2022 performance year, CHPA was one of approximately 40 ACOS—out of a total of 482 participating—able to report electronic clinical quality measures (eCQMs). This was due to a collaborative relationship with the Colorado Community Managed Care Network (CCMCN) who also serves the CHCs.
CHPA member CHCs who participated in the MSSP program in 2022 include:
- Axis Health Systems
- Clinica Family Health Services
- High Plains Community Health Centers
- Inner City Health Center
- Marillac Health
- Mountain Family Health Center
- Northwest Colorado Health
- Peak Vista Community Health Centers
- Pueblo Community Health Center
- River Valley Family Health Center
- Salud Family Health Centers
- Sheridan Health Services
- STRIDE Community Health Centers
- Summit Community Care Clinic
- Sunrise Community Health
- Tepeyac Family Health
- Uncompahgre Medical Center
- Valley-Wide Health Systems
A market-based solution to fragmented and costly care, ACOs empower local physicians, hospitals, and other providers to work together and take responsibility for improving quality, enhancing patient experience, and keeping care affordable. MSSP creates incentives for ACOs to invest in transforming care by allowing them to share in savings generated while meeting defined quality and cost goals.
In 2022 nationally, 482 ACOs caring for 11 million beneficiaries participated in the MSSP, generating gross savings of more than $1.8 billion based on the Centers for Medicare & Medicaid Services methodology for setting financial benchmarks. 405 of the 482 participants, or 84%, achieved a positive savings rate in 2022, and 63% of the ACOs were eligible to receive shared savings payments.
“We are encouraged and inspired by six consecutive years of savings and high-quality care, with 2022 being one of the strongest years of performance to date,” said Meena Seshamani, MD, PhD, CMS Deputy Administrator and Director of the Center for Medicare. “The Shared Savings Program is Medicare’s permanent, flagship Accountable Care Program, and we look forward to continually improving and growing the program, expanding the reach of participating ACOs, and addressing critical health disparities across the country.”