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Published on December 15, 2022

Patients Treated for Less Than Expected — Providers Share $3 Million Payment

The medical care delivered was ranked tops in the nation for quality.

 

Greensboro– The U.S. Centers for Medicare & Medicaid Services will pay Triad HealthCare Network (THN) and its providers $3,094,985 because they cared for patients more efficiently than expected in what is called the Next Generation ACO Model. Of equal significance, THN achieved the highest quality performance score, 99.25%, ranking it number one in the nation in the program. Triad HealthCare Network is a group of medical providers called an accountable care organization (ACO). It was one of 35 ACOs taking part in the Next Generation ACO Model in 2021.   Doctor speaking with patient

ACOs coordinate and standardize care in hopes of lowering the cost of medical services while keeping patient quality high. Triad HealthCare Network agreed to provide a year’s worth of medical care to 27,128 Medicare patients at a set cost. At the end of the 2021 performance period, they had provided that care for millions of dollars less than the budgeted amount. At the same time, THN scored at the very top of the program nationally when it came to quality of care provided. The savings is split with the government, with Triad HealthCare Network earning $3 million.

“I am most proud of the quality of care THN brings to patients. Being at the top of the list nationally for quality of care is extraordinary,” says Elissa Langley, Triad HealthCare Network chief administrative officer. “We have always believed that high-quality care should be more affordable care. These results again prove it.” 

In the Next Generation ACO Model, ACOs must submit quality measurements across multiple areas. THN scored among the top in:

  • Helping people with multiple health ailments avoid hospital stays.
  • Having fewer patients leave the hospital and then soon returning.
  • Communicating with patients.
  • Courteous and helpful office staff.
  • Providing health education.

Not only must the quality be high, but it also has to be efficient. In the program, if the ACO provides high-quality care for less than the government budgets, the ACO shares in the savings. If care costs more, the ACO pays the difference. Centers for Medicare & Medicaid Services has issued quality and financial performance results showing that ACOs have improved patient care and produced hundreds of millions of dollars in savings.

Triad HealthCare Network will reinvest the savings payout for continuous quality improvements and provide performance incentives for physicians and others who partner with them. 

“Every year the challenge is to find ways to deliver very high-quality care in the most efficient manner,” adds Langley. “And every year our team comes through thanks to our exceptional network of providers and an incredibly talented quality department.” 

This is the sixth consecutive year that Triad HealthCare Network will receive money for reducing costs while hitting high scores for quality metrics. THN began the Next Generation ACO model in 2016 and has achieved more than $55 million in savings during its six years in the program.

 o find a list of THN providers please visit them on their organizational website at: https://www.triadhealthcarenetwork.com/thn/.