Aledade ACOs lead Medicare Shared Savings Program for Per-Beneficiary Savings and Diabetes Control, With Every Aledade ACO Earning Quality Score Above 90 Percent
Bethesda, Md. – September 15, 2022 – Today, Aledade announced that its national value-based care network across Medicare Advantage, the Medicare Shared Savings Program (MSSP), commercial payers, and Medicaid has helped independent practices, health centers, and clinics deliver more proactive, preventive, primary care to more than 1.15 million patients, saving more than $1.2 billion across the health care system over the past eight years. These savings went straight to patients and their physicians alike, as practices working with Aledade are projected to have earned more than $167 million in shared savings payments for their work in 2021.
These achievements in quality care and savings are the result of direct improvements to patient care and health outcomes. Eight Aledade accountable care organizations (ACOs) in MSSP received a perfect 100 on their quality scores, and all Aledade MSSP ACOs achieved an average quality score of 94 percent for the year. Through proactive, preventive care, Aledade was able to reduce patient stays in hospitals by an average of 22 percent compared to 2019 (to account for the impact of COVID-19), avoiding more than 24,000 hospitalizations in 2021, as well as reducing Emergency Department visits by 23 percent compared to 2019, avoiding more than 120,000 ED visits.
More specifically, patients of practices in Aledade’s network saw better blood pressure screening, A1C control, and cancer screening rates. Patients got more flu shots, and finally got help quitting smoking. In MSSP specifically, Aledade has three ACOs in the top 10 percent of all ACOs for blood pressure control and statin therapy. An Aledade ACO was also the top performer for diabetes control.
Aledade is bringing its proven model to communities that need it most, and showing that value-based care can deliver better care, improved outcomes, and savings in disadvantaged communities. More than 65 percent of practices working with Aledade are located in federally-designated Primary Care Health Professional Shortage Areas, and nearly half are located in Medically Underserved Areas. In the MSSP specifically, Aledade’s networks serve more than twice the average of patients in low-income communities.
“Together with dedicated primary care professionals across the country, Aledade continues to deliver on our mission to control health care costs in a way that is good for patients, good for doctors, and good for society. Our 2021 results are a direct reflection of that collective effort, and not only show that our model working, but that it’s working across every type of payer, in every type of community, and is getting stronger over time,” said Farzad Mostashari, MD, CEO and co-founder of Aledade.
More shared savings mean more revenue for independent primary care professionals. Nine out of every 10 practices working with Aledade will receive a shared savings check this year and, on average, those practices earned shared savings payments equivalent to more than 20 percent of their annual Medicare fee-for-service revenue, with some earning more than 100 percent.
In 2021, Aledade’s networks saved the traditional Medicare program alone more than $390 million through its national network of ACOs in MSSP. Four of the top 10 performing ACOs in MSSP in per-beneficiary savings for 2021 were Aledade ACOs, and the top-performing MSSP ACO in the entire country was an Aledade ACO (PA MSSP PMA Enhanced). Aledade’s PA MSSP PMA Enhanced ACO achieved this top ranking by delivering superior patient outcomes. For example, with Aledade’s technology and population health management support, PA MSSP PMA Enhanced successfully reached out to 98 percent of recently hospitalized patients and successfully conducted clinical visits with 50 percent of those patients within 14 days of discharge, leading to a 9 percent readmission rate. The average readmission rate for MSSP was 15.4 percent.
Higher-Quality Care, Better Outcomes
Community Health Centers (CHCs) working with Aledade, which serve communities that are lower-income, have elevated health risks, and are considered medically underserved, increased annual wellness visits by 17 percent between 2020 and 2021. As a result of those care improvements, nearly 80 percent of the 115 participating Aledade CHCs earned shared savings, yielding a total of more than $22 million in savings for 2021.
In particular, Aledade’s Mississippi MSSP Community Health Center ACO excelled in 2021, ranking fourth overall for highest 2021 MSSP savings rate, according to the Centers for Medicare & Medicaid Services (CMS). In its 2021 Consumer Assessment of Healthcare Providers & Systems (CAHPS) survey, a quality measure of patient experience, this ACO earned high marks across the board. With Aledade’s technology and on-the-ground support, clinicians in the Mississippi CHC ACO earned a score of 95.24 out of a possible 100 for how well they communicated with their patients. They also received a 92.79 overall rating, ranked second in MSSP, for stewardship of patient resources, and scored a 92.31 for having courteous and helpful office staff.
“In an evolving value-based care environment, Aledade is an important partner in the delivery of care to my patients,” said Dr. Kevin Koehler, Medical Director for the Mississippi MSSP Community Health Center ACO. “I use their claims-based data, insights and resources to improve the quality of patient care while simultaneously decreasing the cost of delivering that care! Aledade has helped me enhance my value-based care perspective.”
In addition, Aledade ACOs across the country saw high achievement across CAHPS measures:
- Physicians in Aledade’s West Virginia ACO, who have been working with Aledade since 2016, ranked first in MSSP for getting timely care, appointments, and information to patients.
- Aledade’s MSSP ACO in Kentucky scored 97 out of a possible 100 for how well providers communicated with patients.
- Aledade’s Western Sky ACO which encompasses practices in Arkansas, Colorado, Texas, Utah, and Arizona ranked second in MSSP for health promotion and education.
By The Numbers
Aledade’s model is creating a better experience for patients while lowering costs across the entire system. Results from CMS from MSSP performance in 2021 show that, ACOs comprising 75 percent or more primary care physicians saw nearly double the Medicare savings per beneficiary than ACOs with fewer primary care physicians. Physician-led ACOs saw $281 in net savings compared with $149 in net savings for ACOs that had fewer physicians, demonstrating that physician-led models continue to see the highest success in value-based care.
Primary care is traditionally the most underpaid specialty and many practices run on small margins with little in reserves. Shared savings generated through value-based care provide valuable revenue that can be reinvested in care delivery.
Aledade’s member practices who earned shared savings will receive more than $117 million in shared savings checks from Medicare for 2021. Aledade’s 75 health plan ACOs (Medicare Advantage, commercial, and Medicaid) are projected to bring in an additional $50 million to practices in shared savings and quality payments led by more than 600 small, independent primary care practices in 19 states. These shared savings payments will provide a much-needed inflow of revenue to keep practice doors open and ensure physicians can continue to serve their communities.
In 2021, Aledade’s multi-state ACO, called Opportunity ACO, supported 356 practices across 28 states by helping them receive the benefits of joining an ACO as soon as possible to best serve the 74,700 lives in their care. Practice participation in Opportunity ACO increased 12x between 2021 and 2020, when only 28 practices were involved. By working with Aledade, physicians and the ACO earned more than $13 million in total savings.
Aledade’s national network has grown since its founding in 2014 and now covers more than 1.7 million patient lives across 1,000 practices in 36 states and the District of Columbia. In addition to rapidly expanding its value-based model to more communities, payers, and populations, Aledade is also leading the industry when it comes to accepting higher levels of financial risk. In 2021, 76 percent of Aledade’s ACOs were embracing downside risk, and 88 percent of those earned shared savings. Through its successful model, Aledade is able to help independent practices better manage their participation in risk- and incentive-based programs that better align payers and providers to improve patient outcomes at a lower overall cost to the system.
Founded in 2014, Aledade is the leading physician enablement company helping independent practices, health centers, and clinics deliver better care to their patients and thrive in value-based care. Through its proven, scalable model, which includes cutting-edge data analytics, user-friendly guided workflows, health care policy expertise, strong payer relationships and integrated care solutions delivered through Aledade Care Solutions, Aledade empowers physicians to succeed financially by keeping people healthy. Together with more than 1,000 practices in 36 states and the District of Columbia, Aledade shares in the risk and reward across more than 140 value-based contracts representing more than 1.7 million patient lives under management. To learn more, visit www.aledade.com or follow on LinkedIn, Twitter or Facebook.