How CommonSpirit Reduced Medicare Spending by $136M

CommonSpirit Health carved out $136 million in savings to Medicare for 2020, while also improving overall outcomes for hundreds of thousands of beneficiaries, the company recently announced.

CommonSpirit Health is a participant in the Medicare Shared Savings Program (MSSP), which began back in 2012 after being designed by the U.S. Centers for Medicare and Medicaid Services (CMS). The overall goal of the program is to improve patient care and curb health care costs.

Currently, CommonSpirit Health operates more than 1,000 care sites and 142 hospitals across 21 states. The health system has about 150,000 employees and 25,000 physicians and advanced practice clinicians total.

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The health system’s home-based care arm CommonSpirit Health at Home is headquartered in Milford, Ohio. It offers specialized home care, home infusion, hospice and medical transportation services nationwide.

Under the MSSP, CommonSpirit has improved care outcomes for 335,000 Medicare beneficiaries through its 14 accountable care organizations (ACOs). Plus, it boasts an average quality score of 98%.

On average, CommonSpirit’s ACOs saved Medicare $9.3 million, surpassing other average ACOs by $1.3 million, according to a press release announcing the news.

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ACOs bring together doctors, hospitals and other care providers to work together and provide coordinated care for Medicare patients. In return, ACOs are paid for the outcomes they deliver — or they can be financially penalized for falling short. Ultimately, the goal is to produce better health outcomes, prevent medical errors and avoid unnecessary duplication of services, as well as to cut overall health care costs.

“Despite the extraordinary challenges the pandemic has posed over the past year, with many patients unable or hesitant to access care, CommonSpirit’s ACO care teams tripled our care coordination engagement and achieved outstanding quality scores,” Dr. Thomas McGinn, executive vice president of physician enterprise at CommonSpirit, said in a press release. “I am proud of their work to proactively engage our patients, especially those most vulnerable and at high-risk, and improve the health and well-being of the communities we serve.”

As a MSSP participant, CommonSpirit has saved Medicare more than $200 million over the past three years. CommonSpirit has pulled it off by increasing annual wellness visits, improving the management of hypertension, enhancing care coordination and innovating its home-based care offerings, according to the press release.

“Many of these long-standing initiatives were accelerated in 2020 as their importance was brought into starker relief by the pandemic,” Dr. McGinn said in the statement. “As a result, our ACOs ramped up to provide 12% more annual wellness visits than the previous year for high-risk patients, while continuing to make gains in chronic disease management.”

In terms of its home-based care offerings, CommonSpirit’s care coordination team collaborates with medical equipment vendors to allow patients to receive home oxygen. The organization also provides intensive home-based rehabilitation and skilled nursing services through in-person and virtual visits.

In terms of virtual visits, CommonSpirit beefed up its telehealth offerings as a large part of its COVID-19 response strategy.

Last year, the company rolled out a remote biomonitoring program, which utilizes a mobile app, voice platform or tablet provided by the company to track a patient’s vital signs. 

“Outcomes for our remote patient monitoring patients are better than those without remote patient monitoring, even though those patients have a higher acuity level, which is interesting to know,” Trisha Crissman, COO of CommonSpirit Health at Home’s home care and hospice division, previously told Home Health Care News. “There’s some sort of ability to feel like you’re in control of your care and your environment.”

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