St. Luke’s Controls Costs, Saves Medicare Nearly $ 20 Million

BETHLEHEM, Pennsylvania., October 7, 2021 / PRNewswire / – St. Luke University Health Network shared $ 18.6 million in savings with the federal government as a reward for controlling costs while providing the highest quality medical care possible for Medicare patients in 2020.

On Monday, St. Luke’s received half of his savings, or $ 9.2 million, because it achieved a quality score of 100% while providing cost-effective care for elderly and disabled patients in 2020.

St. Luke’s is the only health network in Lehigh Valley in 2020 to both achieve a perfect quality score and earn payment from the Medicare Shared Savings Plan (MSSP), which is administered by the Centers for Medicare & Medicaid Services (CMS). News of this historic achievement was published in a recent year-end report.

“St. Luke’s has achieved this remarkable accomplishment by keeping costs lower than expected while providing the highest quality care,” said Ken Berkta, MD, family physician and vice president of clinical integration at St. Luke’s.

A Responsible Care Organization (ACO) consists of healthcare providers who come together on a voluntary basis to provide high-quality, cost-effective care for Medicare and Medicaid patients. St. Luke’s has formed its ACO, which includes more than 1,700 physicians and advanced practitioners, serving 45,000 Medicare patients who have selected primary care physicians participating in the ACO.

In 2020, the Medicare benchmark or the expected cost of patient care in the St. Luke Network, after adjusting for the impact of the COVID-19 pandemic, was $ 470 million. The real cost of care for Medicare has been $ 451 million for more savings $ 18 million. The network achieved a perfect quality score of 100% even during the pandemic, when it was difficult to maintain preventive care tests like breast cancer and colorectal cancer screenings for much of the year in reason for stopping COVID.

St. Luke’s initiatives that have improved care while reducing costs include:

  • Proactive care management services based on artificial intelligence (AI) analytical tools to identify patients most at risk for poorer outcomes
  • Use of evidence-based, patient-centered clinical protocols developed by physicians and other clinical leaders across the spectrum of care, including hospitals, outpatient clinics, home care, and care settings qualified nurses
  • Real-time clinical decision support tools in the electronic health record to facilitate ordering of the most cost-effective tests
  • Focus on preventive care services and other initiatives to reduce avoidable hospitalizations and readmissions

The CMS MSSP was launched in 2013 to stem the ever-increasing cost of healthcare in the United States while maintaining a focus on delivering high quality care.

About Saint-Luc
Founded in 1872, St. Luke’s University Health Network is a fully integrated, regional, not-for-profit network of over 17,000 employees providing services in 12 hospitals and 300 outpatient sites. With a net annual income greater than $ 2.6 billion, the Network’s service area includes 11 counties in Pennsylvania and New Jersey. Dedicated to the advancement of medical education, St. Luke’s is the premier teaching hospital in the Central East Pennsylvania.

SOURCE St. Luke’s University Health Network

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