As 2018 comes to a close, I would like to take a moment to express my gratitude to all of you in the Signature Partners family for our shared commitment to improving quality and reducing overall cost of care for our patient population. 2018 brought us many successes which are the direct result of the engagement of our network physicians working in tandem with our staff. With your contribution we have moved the needle on our quality metrics; our YTD quality scores are showing significant improvements compared to 2017.
In 2018 Signature Partners received a high performing ACO award by Premier Inc., based on our “exceptional performance” score of 90.85 out of 100 for 2017 MIPS reporting. This high score translates into a positive reimbursement adjustment of 1.39% change from 2018 in the 2019 Medicare physician fee schedule for all of the eligible clinicians who were part of our ACO in 2017. This is in addition to the 0.5% inflationary adjustment resulting in a total increase of 1.89% in Medicare reimbursements for 2019. Please note, the maximum reimbursement earned by any practice was 1.88% (i.e. a total of 2.38% including the inflationary increase).
Our quality team continues to make strides in effectively onboarding our network primary care practices during individual meetings and engaging our network primary care practices at the quarterly physician “POD” meetings. There were a total of 33 POD meetings held in 2018! We learned from these sessions and have made some adjustments to encourage all of our primary care practices to attend. If you have not had a chance to attend one this year, please plan to do so in 2019. These meetings are a great way to learn all about our payor programs, quality and cost metrics associated with our gain-share contracts, and to meet with your peers to learn best practices for performance improvement.
Our care management team developed and onboarded a Social Worker and a Pharmacist this year to solidify our multi-disciplinary team in an effort to manage the needs of our most complex patients. The team has achieved the care plan targets for the Innovation Health gain-share, and is ready to effectively manage new patient populations part of various payor contracts in 2019. The addition of our pharmacist has had a positive impact, not only in managing the patients with complex poly-pharmacy needs but also in helping guide our network providers toward more cost-effective medications, resulting in savings for patients and payors! This year we also began a pilot with our Group Purchasing Organization, Premier, Inc. and a few primary care practices to determine if the pharmacy discount program offers a greater savings for our providers than they would obtain individually. If the analysis shows favorability, we will be offering it to our entire network in 2019.
Our IT team has made advances toward establishing and validating many EHR interfaces and has achieved data integrity which has established the foundation to produce consistent, reliable and actionable reporting to our providers. This year our analytics team has been able to provide regular and timely reports identifying patient quality metrics gaps, ED utilization, and high cost prescribing by providers. All of these reports support quality and cost metrics performance improvement.
It has been a big year for network contracting with the addition of several major Value Based Contracts (VBC) – Aetna commercial, Aetna Medicare Advantage, Innovation Health Medicare Advantage and United Healthcare commercial plans. With the addition of these VBAs, our network’s attribution will increase to over 100,000 beneficiaries in 2019. Also, with the addition of 70 new providers this year, we have now grown to be a network of over 1700 ambulatory providers.
We have had a great 2018 and this has been possible due to team work and physicians collaboration. Our team is committed to continued improvement in the area of quality metrics performance, and plans to implement strategies required for achieving significant cost reduction as our Medicare ACO prepares to take risk in 2021. Our Quality Committee and the Board of Directors have been guiding us in identifying the top priorities for reducing cost and developing initiatives to be successful under various value based contracts. Based on the recent discussions during Quality and Board meetings, pharmacy and ED utilization reduction are considered to be the areas of focus next year. With your support our team is prepared to achieve success in these and other areas.
We know that our collaborative environment is working, and together we look forward to achieving new milestones in 2019 and beyond!
Neeta Goel, MD
Medical Director for Quality and Population Health
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