ACO West Virginia earns high quality marks, saves Medicare money – WVU Medicine

ACO West Virginia earns high quality marks, saves Medicare money – WVU Medicine

MORGANTOWN, W.Va. – ACO West Virginia, an affiliate of WVU Medicine and the largest accountable care organization (ACO) in West Virginia, improved care for nearly 40,000 Medicare beneficiaries in West Virginia, Ohio, Maryland, and Pennsylvania, and according to recently released performance data from the federal agency that administers the Medicare Shared Savings Program (MSSP), ACO West Virginia saved Medicare $14.8 million by meeting quality and cost goals in 2021.

A market-based solution to fragmented and costly care, ACOs empower local physicians, hospitals, and other providers to work together and take responsibility for improving quality, enhancing patient experience, and keeping care affordable. The MSSP creates incentives for ACOs to invest in transform care by allowing them to share in the savings they generate after meeting defined quality and cost goals.

ACO West Virginia’s achievements resulted in a shared savings payment of $7.2 million, the largest shared savings payment ever achieved by a West Virginia headquartered ACO. 

Ben Gerber

“These outstanding results highlight what clinicians can accomplish when they have the right tools, technologies, and resources to manage their patients’ health inside and outside of the primary care clinic,” Ben Gerber, ACO executive for ACO West Virginia and chief strategy officer for the West Virginia University Health System, said. “Population health management is our future, and we are proud to be leaders in enhancing our models of care.” 

Medicare data shows that ACO West Virginia also earned a quality score of 88.66 percent on performance measures ranging from preventive health checks to use of computerized health records to prevention of avoidable hospitalizations. 

Kevin Halbritter, M.D.
Kevin Halbritter, M.D.

“When you look at the specialties, procedures, and conditions for which our ACO primary care providers treat, you can see that the issues that most plague the people of the state and region – cancer, diabetes, heart disease, kidney disease, lung disease, and stroke – are among them. There are a lot of people on the teams treating those conditions at our ACO, and we are grateful for their dedication to providing the wraparound care that our patients need close to home where they need it,” Kevin Halbritter, M.D., chief operating officer and medical director of ACO West Virginia, said.

“ACO West Virginia providers work to increase the number of Medicare beneficiaries taking advantage of annual wellness visits, including recommended screenings and preventive care. The ACO also focuses on ensuring smooth patient transitions from the hospital to home or a nursing home, if needed.”

In 2021, 475 ACOs caring for more than 11 million beneficiaries nationally participated in the MSSP, generating gross savings of $3.62 billion based on the Centers for Medicare & Medicaid Services methodology for setting financial benchmarks. After accounting for shared savings earned by ACOs in 2021, estimated net Medicare savings were $1.66 billion.

For more information on ACO West Virginia, visit ACOWV.org


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