BJC ACO Earns Shared Savings from Medicare for 2017 Performance

(Nov. 13, 2018 – ST. LOUIS) – BJC Accountable Care Organization (ACO) is the only integrated health system in the St. Louis area to earn shared savings in 2017, according to data released by the Centers for Medicare and Medicaid Services (CMS). Improved patient outcomes, provided at a more efficient cost for Medicare patients, has resulted in the shared savings, which will be distributed among ACO participating providers and hospitals.

The Medicare Shared Savings Program rewards ACOs that lower health care costs while delivering high quality care. In 2017, ACOs were measured on 32 CMS quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.

The BJC ACO overall quality score for 2017 was 98 percent, eight points higher than the national average of 90 percent. The performance also marked an improvement over BJC ACO’s 2016 score of 92.63 percent.

Costs were reduced through increased tracking and reporting, primary care physician (PCP) education and care management efforts, noted Nancy Kadlec, vice president and chief nursing officer for BJC Medical Group.

“A tremendous amount of work was done to aggregate data and produce reports for the PCPs, skilled nursing facilities and home health reflecting their performance for the previous quarter,” she said. “We also began meeting with providers twice a year to review the reports, discuss ACO initiatives and get their feedback. This forum of sharing information and providing education around the ACOs’ initiatives and defining the providers’ role, helped underscore the importance of this program.”

Megan Guinn, program director, added the ACO’s care management team worked by phone with patients transitioning home from the hospital or with chronic conditions, helping them understand discharge instructions and their medications, providing education on their condition and scheduling follow-up visits with doctors.

“Patients benefit from working with a care manager,” Guinn said. “They help patients stay independent and out of hospitals by providing them with education about their condition and connecting patients and family members to helpful resources. Our work toward preventive care and wellness measures resulted in quality reward points for significant improvement.”

Improving the quality of patient care while lowering health care costs was only possible through better collaboration between patients, physicians and hospitals, according to Doug Pogue, MD, president, BJC Medical Group.

“The BJC ACO provides a full continuum of services through an integrated network of health care delivery settings in Missouri and Illinois,” Dr. Pogue said. “BJC’s network of physicians takes care of seniors in a very positive way. BJC ACO collaborates with physicians for well-communicated care of patients, making patients healthier and allowing us to follow the patient through different care platforms in a more coordinated, transparent way.”

“We have also advanced our technology infrastructure to better meet the needs of our clinical care teams,” said Karen Shakiba, operations program director. “We focused on increasing awareness of our mission throughout the organization and provider communities, and created more transparency through reporting and analytics.”

BJC ACO was also recently recognized by the American Cancer Society for exceeding its national goal of screening over 80 percent of eligible seniors for colorectal cancer.

Doctors, hospitals and health care providers establish ACOs in order to work together to provide a higher-quality coordinated care to their patients, while helping to slow health care cost growth. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside the ACO.