Ochsner Accountable Care Network achieves top-ranking healthcare savings for Medicare.
By Jenna Hughes
The Centers for Medicare and Medicaid Services (CMS) announced data from the 2023 Medicare Shared Savings Program (MSSP) for accountable care organizations (ACOs), with Ochsner Accountable Care Network (OACN) achieving top-ranking results for clinical performance and healthcare savings for the Medicare population.
The CMS Medicare Shared Savings Program aims to save Medicare money while simultaneously supporting high-quality healthcare access throughout the nation. The program yielded more than $2.1 billion in healthcare savings in 2023, according to CMS, which is the largest in the program’s history.
According to the 2023 MSSP report, OACN’s participating physicians and advanced practice providers lowered the expected cost of care by $30.9 million for the more than 58,000 Medicare beneficiaries in its care.
“OACN has successfully reduced the expected cost of care for Medicare beneficiaries in 2023 through a strategic combination of care coordination, technology, and preventive care,” said Eric Gallagher, CEO, Ochsner Health Network. “Key to this achievement is the seamless integration of care coordination across our network, which ensures that healthcare providers work collaboratively to manage patients’ health needs efficiently. This reduces unnecessary procedures and hospital admissions, leading to significant cost savings.”
Despite serving a patient population with significant health disparities, OACN has made many improvements in ACO preventative care, such as increasing annual wellness visits by 37% from 2022, achieving among the top 9% of ACOs in hypertension control and screening for depression and follow-up plans, and nearly 87% of patients received appropriate breast cancer screenings.
ACOs and cost savings
Accountable Care Organizations are groups of doctors, hospitals, and other healthcare providers that collaborate to provide coordinated, high-quality care to people with Medicare, according to CMS. ACOs focus on delivering proper, whole-person care at the right time to avoid unnecessary services and medical errors that often lead to higher healthcare costs.
When ACOs succeed in the delivery of high-quality care at an affordable cost, they may be eligible to share in the savings they achieve for the Medicare Program. ACOs may also share in losses if they increase spending, according to CMS, driving lower health care costs for people with Medicare.
“Accountable Care Organizations (ACOs), like OACN, play a pivotal role in enhancing healthcare delivery while significantly reducing costs nationwide,” said Gallagher. “ACOs bring together groups of physicians, hospitals, and other care providers to ensure that patients, particularly those with Medicare, receive well-coordinated, high-quality care. This collaboration minimizes redundancies and ensures seamless communication among healthcare providers, which leads to more efficient and effective patient care.”
CMS specifically strives to improve preventative care services through ACOs by advancing the integration of technology in healthcare, emphasizing value-based care, streamlining processes, and enhancing communication between healthcare providers.
“Technology integration enables ACOs to perform more precise and effective care coordination, improving health outcomes while reducing costs,” said Gallagher. “Emphasizing value-based care improves the health of beneficiaries and also contributes to cost savings, making healthcare more affordable and sustainable.”
Rural healthcare initiatives
Delivering quality healthcare to rural populations can be especially challenging due to regional lack of access to healthcare. Far distances within these communities from clinicians’ offices and hospitals and lack of infrastructure pose greater health risks to populations in rural regions. Technology advancements within healthcare have significantly helped ACOs bridge these types of care gaps and provide much-needed patient care in remote areas.
“Through the strategic use of technology, ACOs bridge geographical gaps, enabling healthcare providers to reach rural patients more effectively,” said Dr. Sidney “Beau” Raymond,
Ochsner Health Network. “Advanced data-sharing capabilities empower clinicians with the information they need to make timely and informed healthcare decisions, which is crucial in areas where resources may be limited.
In addition to technology, collaboration between clinicians is also a key component to providing coordinated healthcare to rural populations.
“By working closely with local healthcare providers, ACOs ensure that care plans are tailored to meet the specific needs of rural communities,” said Dr. Raymond. “This collaboration fosters relationships built on trust and understanding, which are essential for effective healthcare delivery.”
Attributed beneficiaries can also utilize the Connected Care programs through Ochsner, according to Dr. Raymond, which allow for remote patient management of chronic conditions such as hypertension and diabetes no matter where a patient lives.
Future of ACOs
From performance year (PY) 2022 to PY 2023, ACOs’ nationwide performance improved on many quality measures overall, according to CMS, including statistically significant improvement on data related to diabetes, blood pressure control, breast and colorectal cancer screening, and more.
The Shared Savings Program has now grown into one of the largest value-based payment programs in the country, with 480 Shared Savings Program ACOs, including more 608,000 clinicians who provide care to nearly 11 million people with Medicare.
CMS continues to support Shared Savings Program ACOs in increasing investment in primary care services. The 2023 CMS report specifically showed that out of 453 accountable care organizations nationwide, Ochsner Accountable Care Network ranks in the top 11% for quality.
“OACN is dedicated to continuing to develop healthcare plans that meet the unique needs of each community we serve. By closely collaborating with local clinicians, we ensure that our initiatives are not only effective but also resonate with the specific health challenges of each region,” said Dr. Raymond “Through these goals, OACN aspires to lead the charge in innovative healthcare, fostering healthier communities and setting new standards in accountable care.”
The network’s clinical successes, according to a 2024 Ochsner press release, can be attributed to ensuring appropriate care coordination; increasing primary care visits; focusing on high-risk patient care coordination and support; and improving patient satisfaction.
“Looking ahead, OACN aims to deepen its focus on health equity by addressing disparities across diverse communities,” said Dr. Raymond. “By deploying tailored healthcare solutions, we strive to close the gap in healthcare access and outcomes for all patients.”