Saving millions for Medicare across Michigan: POM ACO reports second-year results

September 1, 2015  //  FOUND IN: Announcements,

A statewide effort by more than 6,300 doctors and other providers, including all U-M physicians, has saved American taxpayers more than $27 million in Medicare spending while improving care for more than 133,000 Michigan seniors, according to new data released last week by the federal government.

The results mean that the effort, called POM ACO, has earned a share of that savings – a total of over $12 million — to fund its efforts to improve care further.

POM ACO is one of 405 accountable care organizations across the country launched under the Medicare Shared Savings Program through the Affordable Care Act.

The new federal report shows that POM ACO saved the Medicare system five times more in the organization’s second year than in its first year. It did so by working to coordinate the care that individuals received from different primary care and specialty providers, and by working to prevent health issues and repeat hospitalizations.

Shared effort, shared rewards

In 2014, POM ACO grew to include all of the University of Michigan Health System’s physicians, who joined existing members from 11 other physician organizations around the state. Together, they now care for 133,000 beneficiaries with traditional Medicare coverage.

POM ACO members cooperate on efforts to improve care for individuals and populations, and to slow the growth of Medicare costs. In return, more than half of any shared savings is earmarked to return to provider practices – most of it for primary care providers. The rest of the shared savings will allow POM ACO to improve its infrastructure to serve all participating providers.

Shared savings aren’t guaranteed. ACOs must hit a certain threshold and meet most or all quality goals in order to earn dollars back from the Centers for Medicare and Medicaid Services. In all, 92 of the 333 shared-savings ACOs earned shared savings for 2014.

“We’re pleased that our second year of teamwork has yielded these results, and yet we know that there is more we can do,” says David Spahlinger, M.D., chair of the POM ACO board and executive director of the U-M Faculty Group Practice. “All of us can take justifiable pride in what we have achieved together. But we know we can perform even better on specific indicators of care quality, and reduce unnecessary hospital readmissions and emergency visits even further.”

Examples of improvement

POM ACO participating groups made good progress in 2014 in reducing the amount of time beneficiaries needed to stay in skilled nursing facilities after some joint replacement operations. Now, they’re working to make that true for other types of post-surgical care.

Many clinics taking part in POM ACO have invested their own funds to hire pharmacists who work as part of their practice, and are available to meet with patients who are already there for a doctor’s appointment or other reason.

POM ACO member groups also have started to offer more wellness visits to beneficiaries, to connect with them about ways to prevent injuries and illness during visits that aren’t focused on a particular medical problem.

A history of improving care & bending the cost curve

Launched in 2013 as a joint venture of the University of Michigan Health System and six physicians groups around the Lower Peninsula of the state, POM ACO complemented the Pioneer accountable care organization that U-M’s faculty physicians already belonged to at the time.

By moving U-M physicians and other providers into POM ACO in 2014, U-M continued its longstanding commitment to new models of care. That commitment began in 2005, with participation in the CMS Physician Group Practice demonstration project that led to the creation of the now-national ACO model.

This is the ninth year in a row in which U-M physicians have saved the Medicare system money by coordinating and improving care as part of innovative federal programs.

For more about U-M’s participation in these efforts, see http://umhealth.me/ACOpop.

Learn more about POM ACO at www.pom-aco.com

In 2014, POM ACO included providers from these organizations:

  • The University of Michigan Health System
  • Advantage Health/Saint Mary’s Care Network
  • Crawford Mercy Physician Hospital Organization
  • Huron Valley Physicians Association (HVPA)
  • Integrated Health Associates (IHA)
  • Lakeshore Health Network
  • MidMichigan Collaborative Care Organization
  • Oakland Southfield Physicians
  • Olympia Medical Services
  • Physicians’ Organization of Western Michigan (POWM)
  • United Physicians
  • Wexford Physician Hospital Organization

A full list of participating clinical locations is at http://pom-aco.com/aco-participants

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