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McLaren ACO 2024 Results
McLaren High Performance Network ACO (MHPN) has been operating since 2017, and Performance Year 2024 is the first time we have exceeded our allotted claims and utilization expenditures benchmark and are required to pay CMS back for those excess dollars. Collectively, our providers spent $10M more than the CMS benchmark and MHPN is required to repay $3M.Although we are extremely disappointed by our performance, we are committed to making changes to improve our results going forward.
Performance Year 2025 began a new 5-year MSSP (Medicare Shared Savings Program) contract. MHPN has modified our participants and removed multiple high-cost provider TINs (Tax Identification Numbers) including McLaren entities.
Despite the negative financial performance there are still benefits of McLaren ACO membership:
- McLaren assumes all the downside risk associated with the MSSP Contract. Providers have no individual risk. McLaren is responsible for the repayment to CMS.
- MHPN ACO providers are excluded from reporting MIPS metrics as MHPN qualifies as an AAPM (Advanced Alternative Payment Model).
- Our 2024 AAPM performance score is 100%.
- In 2025, our ACO members received a 3.5% APM positive payment adjustment, paid as a lump sum payment totaling $1.5 million, based on our 2023 CY MIPS performance.
MHPN is working closely with the Premier Population Health Collaborative and Milliman Actuaries to understand where our greatest opportunities for improvement are.
MHPN Medical Leadership is reaching out to lower performing providers to review cost, coding, and utilization opportunities.
MHPN meets regularly with other Michigan ACOs to develop best practices and understand what other more successful ACOs are doing differently.
MHPN has instituted an AWV (Annual Wellness Visit) program with MMG employed providers. Expansion to independent ACO members will follow.
Resources Provided:
- Population Health Registry- Persivia
- Identifies gaps in care on your attributed patients.
- HCC Coding Assistance Tool
- Cerner- Stanson, Non-Cerner- Persivia CareTrak
- Tool improves coding specificity of chronic conditions leading to higher risk-adjustment (funding) and greater opportunity for shared savings and increased Fee-For-Service payments.
- Quality Field Team
- Local team of Quality Performance Specialists and Practice Coaches that visit individual practices and helps reduce the administrative burden on the offices.
- Assists with data abstraction, gap closure, and quality reporting.
- Care Coordination Team
- Robust team of care management RN’s, LPN’s and MSW’s to assist in the management of patients with chronic conditions.
- Provides extended access hours to an RN for patients that are discharged from the ED or inpatient settings.
- Reporting
- MHPN provides individualized reports monthly to all providers on cost, utilization, and quality performance.
We want to thank you for your continued participation and for the delivery of exceptional care you and your practice provide to our ACO beneficiaries.
Please contact me at [email protected] or (248) 484-4923 with any questions.
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