With seven ACOs across five U.S. states and the District of Columbia, Prominence Health and partnered Clinicians continue to produce meaningful cost savings to Medicare
RENO, NV (September 19, 2023) — Prominence Health announces 2022 Accountable Care Organization (ACO) results with over $79 million in savings to Medicare and more than $57 million in earnings for 3,000 participating physicians. This yields a total of over $450 million saved since the establishment of the first UHS ACO in 2014.
"Value-based care is central to our mission at Prominence Health and we are proud of the providers and team members in our ACOs for once again leading the way," said Kamal Jemmoua, CEO, Prominence Health. "These impressive outcomes reaffirm the potential of providers equipped with the appropriate tools, resources, and technologies to effectively deliver preventive healthcare in their communities.”
ACOs are groups of physicians who agree to reduce costs and increase quality within a value-based contract. Physicians are incentivized with tools to bend the healthcare cost curve, manage utilization, and maintain high-quality care. This is as a result of shifting from volume-based to value-based payment structures and better integrating data and communication across the continuum of care. Within the Medicare Shared Savings Program (MSSP), providers can earn back part of the savings they generate for Medicare by achieving pre-determined cost and quality goals.
“Our team is dedicated to shifting how medicine is practiced in our community from reactive to preventive medicine. Our goal is to improve the patient experience and reduce the financial burden of care within the Medicare program,”said Dr. Monzer Yazji, South Texas Clinical Partners ACO. “We are extremely proud of our physicians, care management teams and staff who continue to focus on the quality of the patient experience.”
Universal Health Services (UHS) ACOs are physician-led and sponsored either wholly by UHS subsidiaries or in a joint-venture partnership with ACO participants depending on the structure of the ACO. The ACOs are centered on primary care with community partnerships in post-acute and specialty care. Hospital sponsorship is a differentiator as the hospitals partner with providers to provide capital funding, tools to better manage downside risk, and integrated ACO-friendly hospital initiatives focused on avoiding unnecessary utilization and increasing communication with ACO providers. The support from UHS facilities allows for ACO leadership and governance to be driven by participating providers in the community — a vital component to success in value-based care.
UHS subsidiaries also provide administrative oversight and data analytics for ACO operations in addition to ACO-friendly hospital initiatives within each UHS facility. These initiatives include PCP notification of ACO beneficiary admit/discharge, ACO patient flags within the hospital EMR, partnerships with hospitalists and ED providers to ensure appropriate utilization, and integrated case management navigating PCP communication and post-acute care.
The Center for Medicare and Medicaid Services (CMS) established the ACO program to improve the quality of care for Medicare beneficiaries and lower Medicare costs. Since the beginning of the ACO program in 2013, ACOs have saved Medicare $8.6 billion.
About Prominence Health
Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members.
Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. For more information about Prominence Health, visit their website.
About Universal Health Services
One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (NYSE: UHS) has built an impressive record of achievement and performance, growing since its inception into a Fortune 500 corporation. Headquartered in King of Prussia, PA, UHS has 94,000 employees. Through its subsidiaries, UHS operates 27 acute care hospitals, 331 behavioral health facilities, 39 outpatient facilities and ambulatory care access points in 39 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.