In 2019, the first year that Mass General Brigham participated in the Medicare Shared Savings Program (MSSP), our system was able to limit cost growth. Mass General Brigham beat the Medicare performance benchmark by 1.9 percent, while maintaining high-quality care for patients—achieving a quality score of 100 percent. Beating the benchmark by 1.9 percent equated to $14.7 million in cost savings for the federally funded program during the 6-month performance period.
By choosing to transition to the MSSP model, Mass General Brigham was able to extend care to roughly 10,000 additional patients, serving a total of approximately 125,000 Medicare patients; as well as an additional 2,000 providers, totaling approximately 9,300 providers supporting the Medicare population. Mass General Brigham transitioned to the MSSP ACO model from its previous Medicare ACO, the Next Generation Accountable Care model, without disruption to patient care. Our system was one of the first Medicare Pioneer ACOs in the country, generating $36.7 million in cost savings for the federally funded program between 2012 and 2016. When Centers for Medicare and Medicaid Services (CMS) phased out the Pioneer ACO Model, Mass General Brigham chose to continue working on a long-term Accountable Care Strategy.
“Our participation in Medicare risk models has been a central component of our expanded commitment to our value-based care strategy,” says Gregg Meyer, MD, President of the Community Division & Executive Vice President of Value Based Care at Mass General Brigham.
The Medicare Shared Savings Program ACO Model rewards providers and health care organizations for delivering high quality, coordinated care, while keeping costs on par with a national spending benchmark. As part of the MSSP ACO Model, provider organizations can assume higher levels of financial risk and reward and are encouraged to implement new care delivery models.
One of the positive outcomes of Mass General Brigham’s MSSP participation in 2019 has been the continued commitment to our skilled nursing facility programs. In 2019, our system successfully re-launched the Skilled Nursing Facility (SNF) Waiver Program after transitioning to MSSP, quickly re-implementing the program under the new model and returning to the SNF waiver use-rates prior to the transition.
The SNF 3-day waiver program remains a cornerstone for the ACO and is key to optimizing site of care, ensuring that Medicare patients get the right level of care at the right time. The program emphasizes appropriate utilization and care transitions and supports discharge planning, helping to transition patients to the right level of care upon discharge. One of the focuses of Mass General Brigham’s post-acute work has been the expansion of a SNF Transitional Care Management Program, with the aim of improving care and monitoring SNF utilization for more Mass General Brigham ACO beneficiaries. The SNF Transitional Care Management Program reduces length of stay by an average of 4 days, and provides a platform for deep collaboration with our SNF partners.
Mass General Brigham:
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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.