OSF HealthCare work as Medicare Accountable Care Organization continues to show positive results

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OSF HealthCare was one of the first organizations selected to participate as a Medicare Accountable Care Organization (ACO) by the Centers for Medicare and Medicaid Services (CMS). In the decade since, the Peoria, Illinois-based health system has continued to expand services throughout the state, increasing access to high quality, coordinated care.

ACOs are groups of doctors, hospitals, and health care providers working together to give Medicare patients better service, better quality and better care at a lower cost. This includes innovative approaches to care management, care coordination and special attention to those with multiple complex medical problems. The goal is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

When an ACO succeeds in delivering high-quality, evidence-based care that leads to improved health outcomes at a lower cost, the ACO shares in the savings it achieves for the Medicare program. In fiscal year 2020, OSF HealthCare saved tax payers $24 million and received a payback of $17.9 million as a result, money that will be reinvested into patient care.

“OSF HealthCare is proud to have earned a quality score of 98.13% in 2020 as a Medicare Accountable Care Organization. The fact that these excellent results occurred in spite of the Covid-19 pandemic was the result of our clinicians’ dedication to providing high quality care to all of our patients we serve,” said Dr. Stephen Hippler, Chief Clinical Officer for OSF HealthCare.

“Over the course of the past ten years OSF has worked diligently as a health care system to develop and build robust team-based primary care medical homes, often first in their communities. Engaging our physicians through development of service lines and local quality committees has driven transparency of performance and adoption of best practice,” explained Dr. Jeffry Tillery, president of OSF Multi-Specialty Services. “Augmenting that care with online scheduling, open notes, extended hours and telemedicine, as well as embedded care managers and behavioral health specialists, has contributed to our phenomenal outcomes.”

Among the successes that helped OSF earn such a high quality score were:

• The ability for an individual to self-schedule a mammogram or access a walk-in screening opportunity;
• Expanded use of in-home Cologuard tests to detect colon cancer;
• Building a culture of safety across all OSF facilities, ensuring all processes are the same and focused on the patient

OSF became one of the first Pioneer ACOs in 2011 because the work fits the philosophy and mission of OSF HealthCare for improved quality, care coordination, and decreased cost for all patients served. OSF believes, like other leading healthcare systems, that focusing and performing well on quality measures will help to keep healthcare affordable by reducing or slowing cost.