The eBrightHealth Accountable Care Organization (ACO) reduced health care spending by $5.1 million, as compared to CMS benchmarks, for 40,000 Medicare beneficiaries in Delaware, Pennsylvania and Maryland, while achieving a Quality Score of 92.17%, according to data released in the U.S. Centers for Medicare & Medicaid Services’ 2019 Performance Results and Quality Report.
“We’ve achieved these impressive results due to the unwavering commitment to our Medicare beneficiaries by our dedicated team of clinicians and health system partners,” said Christine Donohue-Henry, M.D., MBA, president and CEO of eBrightHealth ACO. “Our caregivers are truly transforming care by implementing and refining initiatives that promote improved health for this patient population, delivering the right care, at the right place, at the right time.”
eBrightHealth ACO helps clinicians address clinical, behavioral, social and other needs of Medicare beneficiaries to improve their access to primary care office visits, prevent unnecessary emergency department visits and decrease the amount of time they spend in hospitals. The result is improved quality of life for their patients and reduced health care spending.
Since its founding in 2016, eBrightHealth ACO – currently comprised of 1,500 partnering primary and specialty care clinicians and four health systems – has achieved four consecutive years of savings that total more than $18 million while providing the highest quality of care.
That care is supported by ChristianaCare’s award-winning care coordination program CareVio, which harnesses real-time data and predictive analytics to identify opportunities to help Medicare beneficiaries better manage their health and avoid complications that might lead to unnecessary hospitalizations or avoidable visits to the emergency department.
Due to the public health emergency of the COVID-19 pandemic, CMS provided many ACOs, including eBrightHealth ACO, with the national average quality score of 92.17%. For the 2019 reporting period, eBrightHealth ACO increased the number from last year of beneficiaries who received breast and colorectal cancer screenings, and better controlled blood pressure for those with hypertension.
During performance year 2019, eBrightHealth ACO consisted of four regional health systems — Bayhealth, Beebe Healthcare, ChristianaCare and TidalHealth Nanticoke — nine private primary care practices and two federally qualified health centers, Westside Family Healthcare and La Red Health Center.
Since Jan. 1, 2020, eBrightHealth ACO has participated in the Pathways to Success Medicare Shared Savings Program two-sided risk model in which the partners are eligible for shared savings or liable for increased spending, if it occurs.