Franciscan ACO Performance Results in $14.4M Savings

Franciscan ACO Performance Results in $14.4M Savings

Franciscan Accountable Care Organization (ACO) Inc., a statewide care coordination initiative of Franciscan Health, has earned high marks for its performance in the Medicare Shared Savings Program (MSSP), according to a Centers for Medicare & Medicaid Services (CMS) audit.

As a participant in an ACO, Franciscan partners with physicians, hospitals and other advance practice providers to provide high quality, coordinated care to Medicare patients.

Franciscan ACO earned a quality index score of 94.48 out of 100 percent, outperforming the average quality score of 559 MSSP ACOs, and generating a savings of $14.4 million for CMS in 2018. Franciscan ACO is among only 37 percent of MSSP participating health systems to earn a shared savings bonus as a result of decreasing inpatient stays, emergency room visits, and post-acute care spending and utilization.

Among Franciscan ACO’s quality performance highlights rating 90 percent and above:

  • Consumers/patients praised the quality of communication, expertise and shared decision-making with their doctors
  • Preventive screenings and immunizations
  • Reduction of 30-day readmission rates
  • Effective fall risk measures implemented
  • Tobacco assessment and cessation programs

“We are pleased with our CMS quality performance rating. It clearly demonstrates the MSSP is a sound and effective approach for population health management, increased patient satisfaction and eliminating costly waste within our care delivery system,” said Albert Tomchaney, MD, chief medical officer for the Mishawaka, Indiana-based Franciscan Health. “Franciscan ACO is committed to providing patients with the highest quality of care, working as a team with other participating medical providers to coordinate care across all types of healthcare settings.”

Annually, Franciscan ACO serves more than 198,000 patients throughout Indiana.

“Our program benefits patients by giving them more of a hands-on role in directing their own care while also helping them navigate their healthcare journey from one provider to the next,” said Jennifer Westfall, vice president of Franciscan ACO. “We have placed a strong emphasis on recognizing the impact social determinants of health play in the lives of our patients and make every effort to meet them where they are as we provide care and services.”

The MSSP is a program in which eligible providers, hospitals, and suppliers are rewarded for achieving better health for individuals, improving population health and lowering growth in healthcare costs.

Franciscan ACO participates in similar programs with Anthem Medicare Advantage, Humana Medicare Advantage, and United Healthcare Medicare Advantage.

Franciscan Health was among the first and few to enter the realm of ACO programs which was one of the manifestations of the 2010 Affordable Care Act. With the launch of the Franciscan Alliance Pioneer ACO in 2012, the hospital system began pursuing a more quality centered system of care when Franciscan ACO transitioned from the Pioneer program into the MSSP model in 2015.

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