November 10 2021 – Best Care Collaborative (BCC), a wholly-owned subsidiary of Lee Health, achieved a 97.75% quality rating and $12.1 million in shared savings in performance year 2020 as a participant in the Next Generation Accountable Care Organization (ACO) Model created by the Centers for Medicare & Medicaid Services (CMS).
BCC, which is led by local physicians and providers, and is governed by an independent board of managers consisting of 75% or more practicing physicians, was one of 37 Next Generation ACOs in the country selected to participate in the initiative, the highest risk accountable care organization model.
Next Generation ACO Model differs from traditional models in requiring physicians to take financial risk of the total cost of caring for their patients. This structure incentivizes physicians to coordinate care, develop innovative care models, improve quality and reduce cost to the Medicare program. BCC achieved these cost savings by utilizing robust data analytics, high-risk care management and improved care coordination between primary care physicians, specialty physicians, hospitals, home health agencies and local nursing homes.
“As a patient-centered healthcare organization, participation in the Next Generation ACO provided us with the opportunity to partner with our patients, physicians and other caregivers to provide them the high quality care at the right time, place and cost” said Dr. Scott Nygaard, Lee Health’s chief operating officer. “Our Lee Physician Group participants and partner physicians and providers were instrumental in achieving these savings while improving the quality of care for our region’s Medicare patients. We look forward to continuing to lead the way in provider-led innovation for Southwest Florida.”
In order to share in any savings generated, an ACO must demonstrate that it has met the quality performance standard for the year. Quality of care is measured on 23 measures in four key domains, including patient/caregiver experience, care coordination/patient safety, preventive health and at-risk populations. This is the third year BCC was eligible to earn the quality rating. BCC’s quality score for 2020 reflects the same data as the 2019 quality score, due to the COVID-19 pandemic.
ACOs participating in the Next Generation ACO Model pre-select savings benchmarks, and are committed to providing those savings to Medicare. If the savings are met, the ACO shares in the savings with CMS, while ACOs who fail to reach their savings threshold must reimburse CMS for the difference.
BCC’s share of the total savings is used to cover operating expenses, and the remaining amount is distributed among participating partners, including Lee Physician Group (LPG), Shell Point Retirement Community, Fort Myers Internal Medicine, Healthcare Network of Southwest Florida, Lehigh Pulmonary Associates, Dr. Pedro Ylisastigui, Cypress Family Medical Center and The Listening Doctor for the 2020 performance year.
BCC has participated in the Next Generation ACO Model since 2018.
Learn more about BCC at www.bestcarecollaborative.org.
About Lee Health
Since the opening of the first hospital in 1916, Lee Health has been a health care leader in Southwest Florida, constantly evolving to meet the needs of the community. A non-profit, integrated health care services organization, Lee Health is committed to the well-being of every individual served, focused on healthy living and maintaining good health. Staffed by caring people, inspiring health, services are conveniently located throughout the community in four acute care hospitals, two specialty hospitals, outpatient centers, walk-in medical centers, primary care and specialty physician practices and other services across the continuum of care. Learn more at www.LeeHealth.org.
