APG Members Generated Greatest Medicare Savings From Global and Professional Direct Contracting Model in 2022

October 24, 2023

Washington, DC – America’s Physician Groups (APG) members were among the leading organizations that generated the greatest net savings for Medicare and taxpayers through the Global and Professional Direct Contracting (GPDC) Model in 2022, according to newly released results from the Centers for Medicare & Medicaid Services (CMS).

Bloom Health and Iora Health, now part of One Medical, achieved the greatest net savings rates – equal respectively to 27 percent and 21 percent of “benchmark” or targeted Medicare spending, such as the spending that would have occurred in the absence of the model for these organization’s attributed Medicare beneficiaries. Bloom and Iora Health also earned perfect quality scores overall, achieving targeted metrics in lowering hospitalization for ambulatory care-sensitive conditions; executing timely follow-up after acute exacerbation of chronic conditions; and lowering mortality for patients.

Also achieving net savings and high-quality scores were Direct Contracting Entities (DCE’s) affiliated with these other APG members: agilon health; Arizona Health Advantage (Heritage Provider Network); CareAllies; Castell Direct LLC, a division of Intermountain Healthcare; CenterWell; ilumed; Lumeris; NeueHealth; NW Momentum Health Partners (Physicians of SW Washington); Oak Street Health; Reliant Medical; Triad HealthCare; University of Texas (UT) Southwestern Medical Center; and VillageMD.

“The success of all these APG members in the GPDC model – now ACO REACH (for Realizing Equity, Access, and Community Health) – illustrates the fact that physician-led organizations taking on full accountability for the costs and quality of care for patients produces superior results, both for patients and Medicare,” said Susan Dentzer, President and Chief Executive Officer of APG.  “These results constitute some of the strongest achieved to date by the advanced alternative payment models tested by the federal government.”

According to CMS, 99 so-called DCE’s – provider organizations that contract directly with Medicare to provide care to patients under the GPDC and ACO REACH models – participated in the program in 2022. Of these, 75 produced net savings for Medicare, yielding $371.5 million overall, or 1.6 percent of the model’s Medicare spending benchmark. These 75 DCE’s also earned a share of the savings that they achieved for Medicare, which totaled $484.1 million, or 2.1 percent of the model benchmark.

Since the 2022 performance year, additional APG members have now joined the successor model to GPDC, ACO REACH. It is the first accountable care model in Medicare to address issues related to health equity and access directly, such as through requirements that participants have robust plans for meeting the needs of patients in underserved communities and to make measurable reductions in health disparities.

Through APG’s ACO REACH Coalition, APG members have worked closely with CMS’s Innovation Center to share lessons learned from participating in the GPDC and ACO REACH models and continuing to make refinements. They look forward to ongoing discussions with CMS, which noted in a release that it is “excited to continue learning about the care innovations employed by REACH ACOs to improve quality for their patients.”

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About America’s Physician Groups
America’s Physician Groups is a national association representing approximately 360 physician groups with approximately 170,000 physicians providing care to nearly 90 million patients. APG’s motto, ‘Taking Responsibility for America’s Health,’ represents our members’ commitment to clinically integrated, coordinated, value-based health care in which physician groups are accountable for the costs and quality of patient care. Visit us at www.apg.org.

Contact: Greg Phillips, APG Director of Communications, 202-770-1901