eBrightHealth ACO Improves Care, Reduces Costs by $19.4M

The eBrightHealth Accountable Care Organization (ACO) achieved a quality score of 98.75% — its highest score yet — and reduced health care spending by $19.4 million in 2020, according to recently released performance data by the federal agency that administers Medicare.

This achievement marks the fifth consecutive year that eBrightHealth ACO has reduced health care costs for its more than 40,000 beneficiaries in Delaware, Pennsylvania and Maryland, bringing the cumulative amount saved to more than $37.5 million.

“These incredible results are a testament to our unwavering commitment to our Medicare beneficiaries,” said Christine Donohue-Henry, M.D., MBA, president and CEO of eBrightHealth ACO.

“Our highly dedicated team of clinicians and health system partners stay focused on key elements of their care, including transitions of care, care coordination, information and data sharing, quality improvement and the continual transformation of our practices.

“Our continued emphasis on the health and wellness of our Medicare beneficiaries ensures that they receive 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 ACO engages beneficiaries in their care with newsletters and home mailings about health and wellness.

The result is improved health and quality of life for beneficiaries and reduced health care spending.

For the 2020 reporting period, CMS highlighted eBrightHealth ACO’s performance for increasing the number of beneficiaries who received preventive care and screenings, especially screenings for colorectal cancer and depression.

“Our success in 2020 reflects the diligent work of our participating clinicians and their staff,” said Daniel J. Elliott, M.D., MSCE, FACP, FAAPA, executive director of eBrightHealth ACO.

“All have worked tirelessly to improve patient experience and positively impact the lives of countless beneficiaries over the last five years. We are helping people to be well and stay well – and that is the true mark of an ACO’s success.”

Since its founding in 2016, eBrightHealth ACO’s more than 1,400 partnering primary and specialty care clinicians and four health systems have been supported by CareVio®, ChristianaCare’s award-winning care coordination program. CareVio 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.

For the 2020 reporting period, eBrightHealth ACO consisted of four regional health systems — Bayhealth, Beebe Healthcare, ChristianaCare and TidalHealth Nanticoke — six 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 Centers for Medicare & Medicaid Services (CMS) Pathways to Success Medicare Shared Savings Program two-sided risk model. Under the program, clinical partners are eligible for shared savings or liable for increased spending, if it occurs.