America's Largest Safety-Net Health System Built A High-Performing Medicare ACO

In a recent article in the Health Affairs blog,  the NYC Health + Hospitals ACO (NYCHH ACO) reduced costs by 4–12 percent annually compared to benchmark, while continually improving quality in its first four years.  It is the only ACO in New York State to achieve shared savings in all four Medicare SSP performance years. Overall costs to Medicare have been reduced by more than $31 million, generating shared savings incentive payments of nearly $14 million.

According to the article NYCHH ACO took several key steps to successful performance:

  • Key insights from initial analyses of ACO claims data were major drivers of how NYCHH ACO set strategic priorities and drove performance
  • The NYHHC ACO infrastructure, with site-specific physician champions and administrative leads, encourages local creativity and engagement.
  • In-depth reviews of high-cost patients by local ACO teams informed site-specific program development priorities, with an emphasis on interventions that would have a broader impact beyond the Medicare population.
  • Devote significant focus to identifying effective methods for diffusion of successful locally developed innovations across our ACO.
  • The NYCHH ACO “ACO Population Dashboard” was important for organizing more proactive care delivery. The dashboard synthesizes clinical, financial, and administrative data to highlight actionable opportunities.
  • The Medicare SSP ACO has served as an innovation laboratory for NYCHH ACO value-based payment. The lessons learned are being more broadly applied to other populations in the system, particularly Medicaid and uninsured patients.