JUPITER, Fla.--(BUSINESS WIRE)--ilumed improved care for over 24,000 Medicare beneficiaries in Florida, Texas, New Jersey, and Kentucky while reducing costs, achieving a 100% quality score, and ranking in the top ten for cost savings of all companies in the DCE/ACO REACH program in 2022, according to recently released performance data from the Centers for Medicare & Medicaid Services (CMS). Medicare data shows that ilumed earned a quality score of 100% on all five quality metrics. These performance measures range from risk-standardized all-condition readmission to timely follow-up after acute exacerbations of chronic conditions, among others. ilumed also ranked 8th out of 99 Direct Contracting Entity (DCE)/ACO REACH organizations in net savings and has grown from over 24,000 beneficiaries across 4 states in 2022 to over 56,000 beneficiaries across 10 states in 2023.
“This performance is a testament to our team of servant leaders’ daily collaboration with our physicians and other provider partners to deliver quality care with empathy and compassion, creating positive outcomes for their Medicare patients,” said Debbie Finnel, ilumed’s CEO. “More importantly, this lowering of the total cost of care was accomplished by placing the patient’s well-being and unique circumstances first while maintaining the integrity of Medicare benefits for the over 24,000 patients aligned to our primary care physicians.”
In addition to high quality scores, ilumed achieved $30,980,318 of gross savings for Medicare and $23,609,820 of net savings, which will be shared with qualifying physician partners, invested in infrastructure and resources to further improve quality of care, and used to address social determinants of health -- including providing healthy food to those who are food insecure, providing transportation to physician and pharmacy appointments, and eliminating PCP copays and deductibles.
Dr. Eric Weiner, an ilumed primary care physician, has found the relationship with the DCE/ACO REACH model especially beneficial. “ilumed helps my physicians deliver care at the highest level of their license through their patient outreach, assisting in the coordination of care and streamlining our population health management data flows,” said Dr. Weiner. “They also introduced to my practice ways to improve patients’ transition of care through the healthcare continuum.”
ilumed achieved a 100% quality score on account of its programs and efforts, such as:
- Encouraging providers to see their Medicare beneficiaries every 90 days and within 72 hours following a hospital discharge
- Member outreach representatives who guide each patient through difficult situations that often reduce access to care, creating negative health outcomes
- Ensuring smooth patient transitions from the hospital to home
- Giving ACO providers detailed information about their performance on quality measures
- Clinicians and providers utilizing ilumed’s proprietary technology platform, BrainStream, to coordinate the care beneficiaries receive from primary care and specialty providers to prevent health issues and readmissions
In January 2023, CMS transitioned the Direct Contracting Entity (DCE) model to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) model. ACO REACH represents a significant step forward in promoting equitable healthcare outcomes, fostering improved patient access, and strengthening community health engagement.
A market-based solution to fragmented and costly care, Accountable Care Organizations (ACOs) empower local physicians, hospitals, and other providers to work together and take responsibility for improving quality, enhancing patient experience, and keeping care affordable. ACO REACH creates incentives for ACOs to invest in transforming care by allowing them to share in savings they generate after meeting defined quality and cost goals.
**The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.**
About ilumed
ilumed is an ACO REACH organization based out of Jupiter, FL. ilumed grew from over 24,000 beneficiaries across 4 states in 2022 to over 56,000 beneficiaries across 10 states in 2023. We are dedicated to improving the lives of our patients by uniting clinicians with a focus on delivering healthcare with empathy and compassion.
About the CMS ACO REACH Model
Initially launched as the Direct Contracting Global/Professional model by CMS’ Center for Medicare and Medicaid Innovation (CMMI) in 2021, the ACO REACH model began in 2022 and aims to improve the quality of care for people with Traditional Medicare through better care coordination and by increasing access to accountable care in underserved communities. Innovative features the Model will test include benchmark adjustments to shift payments to better support care for the underserved and enhanced Medicare benefits, including care in the home. For 2023, the ACO REACH Model has 132 ACOs, with 131,772 healthcare providers and organizations providing care to an estimated 2.1 million beneficiaries.
Additional information about the CMS ACO REACH can be found at www.medicare.gov.
