We're succeeding at keeping more people out of the hospital. Together, we'll do even better. 

It used to be that when you saw the doctor, you paid for the visit. And when you were screened for a condition, you paid for the test. But innovative health systems like ours helped usher in a new era — one that aimed to reward value over volume in medical care.

We began prioritizing getting patients the right care in the right place at the right time. We entered risk-based insurance contracts, in which health systems receive a flat fee to cover the cost of a patient's care for the year, tying health outcomes to profits. 

Now, more than 25 years later, we have evolved into Advocate Health, which cares for more than 2.2 million people through 108 value-based contracts in six states. We strive to not only treat people when they're sick, but also to keep them healthy and out of the hospital. That helps us lower the total cost of care. And as a new organization formed by the combination of several excellent health systems, our enterprise is poised to help even more people live fully.

Advocate Health's affiliated accountable care organizations generated $128.2 million in total savings through the federal Medicare Shared Savings Program in 2022, according to the latest data from the Centers for Medicare and Medicaid Services. The voluntary program aims to encourage groups of providers to meet benchmarks for quality care while lowering health care costs. Among the first providers to join the program in 2012, our ACOs have saved more than three quarters of a billion dollars to date. 

We're grateful for the innovative programs such as MSSP that foster and encourage value-based care models and help push providers like us and the industry at large in that direction. We greatly appreciate the support Congress is providing to accelerate this transition and encourage lawmakers to continue this momentum by passing the Value in Health Care Act. This bipartisan legislation would make important reforms to maintain and further strengthen Medicare's movement towards high-quality care in which financial performance is linked to the quality of patient care rather than the number of services delivered.

Helping people live healthier lives 

Taking on the financial risk that comes with entering value-based payment arrangements isn't easy. To do it well, we invested in new infrastructure, new expertise and new ways of providing care. And increased scale helps us absorb financial risk.

It's working. 

Our MSSP achievements are the result of our deep commitment and a willingness to build better solutions from the ground up. To help our physicians and advanced practice providers manage patients' chronic conditions and avoid costly visits to the hospital, we've created a best-in-class network of care managers, social workers, pharmacists and other health care professionals who stay in regular touch with patients and their families. These experts help people overcome barriers that might prevent access to medications, specialty visits or other care that they need, and serve as a support network as patients take steps to make healthy lifestyle changes.  

These teams also help smooth the transition as patients leave the hospital. They ensure that patients and their loved ones understand the medications, follow-up visits and additional care that will be necessary, and they help with scheduling and other administrative needs. This is critical, because the easier care is to navigate, the more likely people will stick to their prescribed care plan after they leave the hospital. That prevents unnecessary emergency room visits and helps patients achieve their health and wellness goals.  

But remarkable teams alone aren't enough. These experts need technology and infrastructure to help them understand their patients' needs and efficiently coordinate patient care. We're proud to have invested in the systems that make value-based care successful.   

Building a healthier tomorrow  

Value-based care is widely acknowledged to be the future of health care. Still, our industry has been slow to transition because making the leap is complex and requires a significant investment.

Ongoing support for this transformation through programs like MSSP and the relatively new ACO REACH is critical for the industry to have success, and approval of the Value in Health Care Act would be a big step forward. We hope this bipartisan legislation advances.

These programs help push the industry into the future and reward providers like us for an innovative approach to taking care of our patients. After all, when we can find new ways to keep people living fully while lowering costs in the process, it's our patients who ultimately benefit the most.  

Dr. Gary Stuck is Chief Medical Officer at Charlotte, N.C.-based Advocate Health.

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