Sustaining and Advancing MSSP ACO Performance for OSF Medical Group

Ongoing sustainment and optimization of OSF HealthCare Medical Group’s Medicare Shared Savings Program (MSSP) ACO performance, ensuring continuous alignment with CMS value‑based care requirements while driving improvements in quality, cost stewardship, and patient outcomes. Through cross‑functional collaboration with Operational Leadership, Clinical Practice, Care Management, Analytics, and Population Health teams, I support the development of high‑reliability workflows, strengthen performance on ACO quality measures, and embed value‑based care principles into daily clinical operations. This sustained strategy contributed to $32.3 million in shared savings in 2024 and $29.2 million in 2023, reflecting strong financial performance and consistent delivery of high‑quality, patient‑centered care.

Key Challenges Addressed

To improve quality and reduce unnecessary utilization, I help lead:

• Standardized workflows for preventive screenings, chronic disease management, and care transitions.

• Enhanced documentation and coding processes to support accurate risk adjustment.

• Integration of ACO requirements into daily clinical operations and EMR workflows.

These improvements reduce variation and strengthen reliability across the system.

Project Goals

• Maintain and improve MSSP quality performance year over year.

• Reduce avoidable utilization, including ED visits, readmissions, and inpatient admissions.

• Strengthen chronic disease management and preventive care compliance.

• Improve documentation accuracy and risk adjustment integrity.

• Enhance care coordination and patient experience across the continuum.

• Ensure readiness for evolving CMS requirements and future value‑based programs.

1. Cross‑Functional Alignment & Governance

2. Performance Monitoring & Data Transparency

3. Workflow Optimization & Standardization

I partner with:

• Operational Leadership to operationalize ACO strategies across clinics.

• Clinical Practice to embed evidence‑based care pathways.

• Care Management to strengthen transitions of care and high‑risk patient outreach.

• Analytics & Population Health to monitor performance and identify gaps.

4. Care Coordination & High‑Risk Patient Management

Outcomes & Impact

1. Strong Financial Performance

• $32,303,385 in shared savings in 2024

• $29,220,859 in shared savings in 2023

• These results reflect consistent year‑over‑year improvement and strong stewardship of patient resources.

2. High‑Quality Clinical Performance

2024 CMS quality results show strong performance in key areas, including:

• Influenza Immunization (73.04% vs. national 68.6%)

• Colorectal Cancer Screening (82.41% vs. national 77.81%)

• Statin Therapy (88.52% vs. national 86.5%)

• Diabetes A1c Poor Control (7.09% vs. national 9.44%, lower is better)

• These results demonstrate effective chronic disease management and preventive care strategies.

3. Reduced Avoidable Utilization

Targeted interventions contributed to reductions in:

• Avoidable ED visits

• Readmissions

• Unnecessary inpatient utilization

4. Strengthened Risk Adjustment & Documentation Integrity

Improved documentation workflows supported accurate risk scoring and enhanced financial performance.

5. Embedded Culture of Value‑Based Care

Through sustained education, workflow integration, and leadership alignment, value‑based care principles are now part of daily clinical practice across the Medical Group.

Summary

Ongoing sustainment and optimization of OSF HealthCare Medical Group’s MSSP ACO performance, driving cross‑functional strategies that strengthen quality outcomes, reduce avoidable utilization, and enhance value‑based care delivery. This work contributed to $32.3M in shared savings in 2024 and $29.2M in 2023, supported by strong CMS quality performance and a high‑reliability approach to patient‑centered care.

• Variation in quality performance across clinics and service lines.

• Gaps in preventive care and chronic disease management workflows.

• Need for improved risk adjustment documentation and coding accuracy.

• Fragmented care transitions leading to avoidable utilization.

Sustainment Strategy

Working with Analytics and Population Health, I support:

• Monthly and quarterly performance reviews.

• Dashboards tracking quality measures, utilization, and cost trends.

• Identification of clinics or populations needing targeted interventions.

This creates a proactive, data‑driven approach to performance management.

I collaborate with Care Management to:

• Improve outreach to high‑risk and rising‑risk patients.

• Strengthen post‑discharge follow‑up processes.

• Reduce avoidable ED visits and readmissions.

• Support chronic disease management programs that improve long‑term outcomes.

This ensures patients receive timely, coordinated, and proactive care.

5. Education, Engagement & Change Management

To sustain performance, I support:

• Provider and staff education on ACO measures, workflows, and documentation expectations.

• Engagement strategies that reinforce the “why” behind value‑based care.

• Feedback loops that celebrate success and address barriers.

This builds a culture of accountability and continuous improvement.