Buffalo, N.Y. (September 15, 2020) – Optimum Independent Practice Association (Optimum IPA) a leader in healthcare transformation in Western New York, announced that during their first six (6) months of participation in the Medicare Shared Savings Program (MSSP) they have generated savings of 3.3% or just over $3 million dollars through the Centers for Medicare and Medicaid Services (CMS) contract. Optimum joined the Shared Savings Program in July of 2019 and covers care for approximately 16,000 traditional Medicare beneficiaries.
According to CMS, the Medicare Shared Savings Program, an accountable care organization (ACO) model serving over 14 million seniors and the dominant value-based care program in Medicare, continued its trend of lowering the rate of Medicare spending while providing high-quality care, as evidenced by 2019 performance data released.
ACOs collectively saved Medicare $1.19 billion after accounting for shared savings bonuses and collecting shared loss payments. The results continue a strong and growing trend of the Medicare ACO program saving money.
According to Mark Zygaj, Optimum IPA’s Executive Director “We are a group of healthcare providers who came together to coordinate healthcare services and engage in value-based payment models to streamline and optimize the quality of care for Medicare fee-for-service beneficiaries while reducing health care cost.” Zygaj also explained that “this is achieved by using actionable data and best practices to reduce duplication and unwarranted variations in care, close gaps in care, deliver effective preventive care, and coordinate services across the care continuum, thus producing better outcomes for healthcare dollars spent.”
Thomas F. Hughes, III, MD, Chief Medical Officer of Optimum IPA explains that “as an ACO our goal is to deliver high-quality, cost-effective care through improved population health management and collaboration, and to provide our physicians with administrative and clinical tools so that they are able to focus on the delivery and coordination of patient care and are compensated appropriately as the reimbursement model shifts from fee-for-service to value based. It is due to our exceptional providers, physician and hospital leadership, and their dedication to improving the quality of patient care and willingness to come to together to work collaboratively that we were able to achieve these results so quickly.”
The Medicare Shared Savings Program (MSSP) is committed to achieving better health for individuals, better population health, and lowering growth in expenditures. MSSP offers different tracks that allow ACOs to select an arrangement that makes the most sense for their organization, and is an important innovation for moving CMS' payment system away from volume and toward value and outcomes. It is an alternative payment model that promotes accountability for a patient population, coordinates items and services for Medicare fee-for-service beneficiaries, and encourages investment in high quality and efficient services.
Optimum IPA is a network of over 300 physicians who are dedicated to the pillars of the Patient Centered Medical Home and decreasing costs while improving quality and patient satisfaction with the goal of building a healthier Western New York community. Optimum’s provider composition is a mix of single and multi-practitioner practices as well as larger, multi-specialty practices, who work closely with Kaleida Health and Erie County Medical Center.
Optimum works collaboratively with physicians and the health systems to understand the struggles practices face and many of the resources and services provided by Optimum are geared towards supporting practice transformation, enhancing the patient experience, reducing administrative burdens, improving population health management and most importantly, promoting a more clinically integrated healthcare system in Western New York.
The Centers for Medicare and Medicaid Services (CMS) provides health coverage to more than 100 million people through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace. CMS seeks to strengthen and modernize the Nation’s health care system, to provide access to high quality care and improved health at lower costs.