New York Medical Partners ACO, LLC (NYMP), an accountable care organization (ACO) managed by the Mount Sinai Health System, met quality and cost goals for the management of about 50,000 Medicare beneficiaries in the Medicare Shared Savings Program, resulting in more than $28 million in savings to Medicare, according to recently released performance data from the Centers for Medicare & Medicaid Services (CMS). The $28 million of gross savings to Medicare resulted in a shared savings payment of about $11 million to NYMP.
An ACO is a network of health care providers that shares accountability for providing coordinated care to patients with the hope of limiting unnecessary spending and improving quality and patient experience of care. CMS' Medicare Shared Savings Program creates incentives for ACOs to invest in transforming care by allowing them to share in the savings they generate.
"Our approach at NYMP is to support our primary care providers' care delivery with tailored programs for patients delivered by a multidisciplinary care team and informed by our data systems and analytics. Care management nurses, social workers, pharmacists, and navigators enhance the clinical care our patients receive by addressing their diverse needs. Our goal is for patients to need fewer hospitalizations and receive more care in their own homes," said Denise B. Prince, Chief Operating Officer, NYMP, and Senior Vice President and Chief Operating Officer, Population Health, Mount Sinai Health System.
"At NYMP, we recognize and acknowledge that primary care doctors and specialists work closely together to improve patient outcomes, supported by people and technology to better manage chronic illnesses. We are proud to be a leader in continually improving our models of care," said Robert W. Fields, MD, MHA, Chief Medical Officer, NYMP, and Executive Vice President and Chief Population Health Officer, Mount Sinai Health System.
NYMP's investment in data systems and analytics gives the ACO insight into who is at risk for health problems or hospitalization, allowing the ACO to customize its support to the specific needs of each patient. Its care management team members facilitate smooth transitions for patients from the hospital to home or a community setting, helping set the patients up for success and preventing health issues or re-hospitalizations.
During the challenges of the COVID-19 pandemic, NYMP placed a greater focus on using technology such as telemedicine and remote patient monitoring to interact with patients. Starting in 2020, Mount Sinai enrolled high-risk, hypertensive Medicare patients in a new remote patient monitoring program to monitor their blood pressure. This monitoring extends the reach of clinicians, who receive a continuous feed of their patients' real-time health data, and can intervene as necessary.
"The ability to monitor patients in their home during the pandemic—and on an ongoing basis—is critical," Dr. Fields said. "Additionally, we focused on our most vulnerable patients, who bear the consequences of disparities in care, in part due to lack of technology access. This program requires no technology from the patient and comes at no cost for the device, with little to no cost for service."
NYMP also leverages Mount Sinai's robust Mount Sinai at Home program, which uses an integrated care model to treat patients who are homebound or have trouble accessing care outside their home. Patients can see a visiting doctor in the comfort of their own home, as well as receive a multitude of services in their home such as hospitalization, palliative care, and rehabilitation.
"There are a variety of factors that contributed to NYMP's success in 2020, not the least of which are our investment in both technology and people resources. Payment systems that promote accountability by rewarding value and outcomes help to drive innovation in how care is provided. We look forward to continuing on our path to advance quality, efficiency, and equity in health care," concluded Ms. Prince.
