In 2020, Mass General Brigham participated in the second performance year of the Medicare Shared Savings Program (MSSP) a voluntary federally funded program model that encourages healthcare providers and organizations to come together as an Accountable Care Organization (ACO) to deliver high-quality care. The Mass General Brigham Medicare ACO serves approximately 130,000 Medicare patients supported by a coordinated network of approximately 9,200 providers. In 2020, the Mass General Brigham participating providers performed 4.5% favorably and achieved a quality score of 96.87%. As a result, Mass General Brigham generated $46.7 million in shared savings during the 2020 performance year.
Mass General Brigham was one of the first Medicare Pioneer ACOs in the country. When the Centers for Medicare and Medicaid Services (CMS) phased out the Pioneer ACO Model, Mass General Brigham transitioned to the Next Generation Accountable Care model, followed by continued focus on long-term accountable care strategy with MSSP participation.
“Our commitment to value-based care helped prepare our system in responding to the challenges of the COVID-19 pandemic. Robust infrastructure of existing programs were quickly pivoted to adapt to best serve our Medicare beneficiaries,” says Lindsay Jubelt, MD, MS, Chief Population Health Officer and Chief Medical Officer for Mass General Brigham’s insurance entity AllWays Health Partners.
Under the strain of the COVID-19 pandemic, care delivery programs across the system were able to rapidly adapt and accommodate a shift-in-care strategy while maintaining commitment and dedication toward improving high-quality care for the Medicare population. One distinguished program that highlights these efforts is the Integrated Care Management Program (iCMP), which supports and coordinates health care for primary care patients with complex health issues. During 2020, iCMP pivoted to remote care delivery with the implementation of virtual visit technology, proactive patient outreach, distribution of COVID-19 care kits to high-risk patients, and identifying gaps in treatment due to deferred care.
In addition, utilizing the relationships and expertise of Skilled Nursing Facility (SNF) Transitional Care Managers and the SNF Collaborative, the SNF program was able to anticipate barriers and patient needs and develop best practices to ensure that safe, quality care continued for Medicare patients throughout the pandemic. The SNF program successfully reduced length of stay and enabled increased emphasis on appropriate utilization and care transitions.
As the demand for care in the home increased with the onset of COVID-19, population health management leaders fast-tracked the implementation and launch of the Mobile Integrated Health (MIH) program six months ahead of schedule. The MIH program is an innovative delivery model that treats patients in their homes, relieves strain on hospital capacity, reduces infection risks, and greatly improves patient satisfaction. Mass General Brigham continues to develop home-based care offerings to serve our patients and coordinate care across the continuum and into patients’ homes.
Leveraging existing value-based care infrastructure, including adaptation of the iCMP program, SNF program, and MIH program, served as a cornerstone of Mass General Brigham’s response to COVID-19 and ensured uninterrupted care delivery to Medicare patients.
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Mass General Brigham is an integrated academic health care system, uniting great minds to solve the hardest problems in medicine for our communities and the world. Mass General Brigham connects a full continuum of care across a system of academic medical centers, community and specialty hospitals, a health insurance plan, physician networks, community health centers, home care, and long-term care services. Mass General Brigham is a nonprofit organization committed to patient care, research, teaching, and service to the community. In addition, Mass General Brigham is one of the nation’s leading biomedical research organizations with several Harvard Medical School teaching hospitals. For more information, please visit massgeneralbrigham.org.