How Shared Savings are Distributed

How Shared Savings Are Distributed

Northern Michigan Health Network (NMHN) will distribute 60% of the savings to participants utilizing various measure types from the 33 Medicare Shared Savings Program measures to determine the amount of the payment. The ACO Governing Board will make the final determination regarding specific measures and measure weights with input from NMHN Quality Committees (who will have reviewed and analyzed data available to identify opportunities) and ACO participants (for example, ACO participants may identify obstacles that impede progress in achieving the goals and actions could be taken to eliminate obstacles).

The measures used will be the 33 MSSP measures. NMHN will focus on measures where it sees opportunity to improve and chooses to drive improvement through financial incentives. These measures will be selected to support the NMHN mission to improve the health of Northern MI’s population, improve its residents’ experience of health care, and reduce health care costs.

The measure will be specific and relevant to the participant type. The CMS ACO measures will be utilized when appropriate at a participant level. Participant performance on a specific measure will be compared to the performance of other NMHN ACO participants of the same type to determine payment amount. The categories of the measure types which may be utilized are: patient/caregiver experience, care coordination, preventive care, at-risk populations.

NMHN will keep 40% of the savings to reinvest in the ACO infrastructure including items such as technology, provide education as needs are identified, and assist with redesign of care delivery processes.

 

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