January 13, 2021 – Best Care Collaborative (BCC), a wholly-owned subsidiary of Lee Health, achieved a 98 percent quality rating and $7 million in shared savings in performance year 2019 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 percent or more practicing physicians, was one of 41 Next Generation ACOs in the country selected to participate in the initiative, the highest risk accountable care organization model. Next Generation ACOs differ 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 organization, participation as a Next Generation ACO provided us with the opportunity to partner with our patients to find improved ways to get patients the right high quality care at the right time,” said Scott Nygaard M.D., Lee Health chief operating officer. “Our Lee Physician Group participants and partner 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 quality measures in four key domains, including patient/caregiver experience, care coordination/patient safety, preventive health and at-risk populations. This is the first year BCC was eligible to earn the quality rating.
“Quality has always been a top priority at Lee Health. This achievement demonstrates that our focus, hard work and dedication to quality is paying off,” said Venkat Prasad M.D., MBA, MHA, FAAFP, chief medical officer of Lee Physician Group. “We remain committed to providing safe, effective, high quality patient-centered care across our network of physicians and partner providers.”
ACOs participating in the Next Generation Model preselect 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, Healthcare Network of Southwest Florida, Lehigh Pulmonary Associates and Dr. Pedro Ylisastigui for the 2019 performance year. BCC has participated in the Next Generation ACO Model since 2018 and plans to continue through 2021.
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.
