Physician-Owned Organization Saves Medicare Millions while Helping Patients

Alliance Accountable Care Organization Lowers Cost of Care while Improving Patient Quality.

Austin, TX – Just two years into operation, physicians in Alliance Accountable Care Organization (ACO) are touting success in their goals to provide better patient care, lower costs, and improve health outcomes.

Alliance ACO physicians saved the Medicare program $6.6 million while caring for 11,600 central Texas patients, according to a new report by the Centers for Medicare and Medicaid Services (CMS). Alliance did so while scoring in the 99th percentile on quality measures, including patient satisfaction, preventative care, managing high-risk conditions such as diabetes and heart disease, and patient safety. CMS recently released the results of its 2017 Medicare Shared Savings Program (MSSP). Alliance ACO was one of the roughly one-third of 472 MSSP ACO participants that saved money while improving care, so they could share their cost savings with CMS.

“The unique patient-physician relationship is key to our success,” said Garth Vaz, MD, a solo family physician from Gonzales who is co-president of the group. “As primary care physicians we can have candid discussions with patients and their families about the importance of disease prevention and managing chronic conditions while helping them avoid redundant tests and costly or unnecessary procedures.”

In 2015, a core group of nine primary care physicians from Kerrville and rural communities such as Gonzales, Shiner, La Grange, Weimar, and Yoakum worked with TMA PracticeEdge, a subsidiary of the Texas Medical Association (TMA), to form Alliance, a physician-owned ACO. They opted for this physician-collaboration approach as many other physician groups in Texas instead partnered with hospitals to cut costs and survive the changing health care landscape. With the help of TMA and an investment from CMS designed to assist rural physicians, Alliance gathered funds needed to join the MSSP program in Jan. 2016. Today, Alliance ACO consists of 48 primary care physicians and has expanded to include practices in Austin, Victoria, and Fredericksburg.

The group’s first performance year in 2016 was a primer on learning to work with each other and their ACO management team, Innovista Health Solutions, led by Vice President Crystal Ecton. Ms. Ecton and her team worked with physicians to collect and interpret quality and cost data to better patient care. By 2017, Alliance improved after-hours access to care and coaxed more patients to annual wellness visits. As a result, 9 percent fewer patients had to visit an emergency department, and they required 14 percent less hospital care.

“This hasn’t been easy, but I know we are making a difference because I continue to see real results,” said Alliance member David Sprouse, MD, with Kerrville’s Family Practice Associates. “I cannot stress enough the importance of reaching out to patients to remind them of their annual wellness visits. It gives me an opportunity to monitor those with chronic conditions, and to address social issues that could send a patient to the ER or result in hospitalization.”

As a reward for their efforts, Alliance ACO physicians will share in the savings generated with CMS, setting aside a portion of their earnings to invest in care programs that support continuous improvement over the next several years.

Alliance ACO founder and co-president, Martin Franklin, DO, offered a strategic look into the ACO’s future. “We’ve set a high bar for ourselves, but there is so much more to be done. We look forward to implementing post-hospital discharge programs to ensure our patients get the right care in the right setting and to avoid going right back into the hospital,” he said. “We’ll also work with specialists who offer high-quality, cost effective treatment options for our patients, and implement technologies that will help us improve communications across the health care team.”

Alliance ACO is making a difference in how care is delivered in these Texas communities.

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Media Contacts:

Kimberly Harmon, TMA PracticeEdge

O: (512) 370-1650 | C: (512) 378-1300 | kim@tmapracticeedge.com

Brent Annear, Texas Medical Association

O: (512) 370-1381 | C: (512) 656-7320 | brent.annear@texmed.org

About Alliance ACO

Alliance ACO is a physician-led accountable care organization composed of primary care physicians in south and central Texas, including Austin, Fredericksburg, Gonzales, Kerrville, La Grange, Shiner, Victoria, Weimar and Yoakum. Alliance physicians are dedicated to improving quality outcomes, enhancing their patients’ care experience, and making more efficient use of health care dollars. For more information visit www.alliance-aco.com.

About TMA PracticeEdge

A subsidiary of the Texas Medical Association, TMA PracticeEdge is a trusted ally in creating and managing physician-owned accountable care organizations to support independent primary care physicians in value-based care delivery and payment models. TMAPE currently sponsors 15 ACOs across Texas representing 230,000 patient lives. To learn more about TMA PracticeEdge email info@TMAPracticeEdge.com or call (888) 900-0334.

About TMA

TMA is the largest state medical society in the nation, representing more than 51,000 physician and medical student members. It is in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.