Q&A · ACCOUNTABLE CARE Advocate Aurora Health CMO Dr. Gary Stuck

Unpacks the System’s MSSP ACO Success Shortly after CMS released its most recent result for ACOs participating in the Medicare Shared Savings Program (MSSP), Dr. Gary Stuck, the health system’s CMO, spoke regarding his organization’s major successes in the program By Mark Hagland


n August 26, leaders at the Downers Grove, Illinois- and Milwaukee, Wisconsin-based Advocate Aurora

Health posted a press release to the organi- zation’s website announcing breakthrough results on the part of the integrated health system’s three federal accountable care organizations (ACOs.) As the press release stated, “Data

released by the Centers for Medicare & Medicaid Services (CMS) show that Advocate Aurora Health’s three affiliated Accountable Care Organizations (ACOs) combined generated the highest savings of any integrated health system in the nation in the 2020 Medicare Shared Savings Program (MSSP). Advocate Aurora gener- ated $110 million in savings, the system’s best performance yet despite the immense challenges of the pandemic. The 2020 effort brings Advocate Aurora’s total savings for the federal government and taxpayers to more than $423 million since joining the program in 2012. The 28-percent improve- ment over 2020’s total savings came as teams in Illinois and Wisconsin continued to help each other learn and improve in the years after the 2018 merger, provid- ing high-quality, highly coordinated care while managing costs,” the press release stated, adding that “Those results reflect Advocate Aurora’s unwavering commit- ment to value-based care, lowering costs for patients and other payers while provid- ing the highest quality care possible. “Last year we established that once we

were beyond this pandemic we wanted to be remembered for three things - for tak- ing good care of our team members, our patients and our community,” Advocate Aurora Health CEO Jim Skogsbergh said in a statement contained in the press release. “While the pandemic isn’t over just yet, we continue to pull together, combining the skills of teams in Illinois and Wisconsin and putting our scale to work for our patients. Our results in this program put hard

numbers on what we always say is true: We know how to help people live well.” The press release noted that “Several initiatives across Advocate Aurora’s con- tinuum of care contributed to improved patient outcomes and cost savings. Notable wins included: • Being fully integrated and aligned, put- ting ambulatory and inpatient care under one leadership structure • Transition

of the Illinois Care

Management team to Epic’s Healthy Planet Population Health platform, and full integration with all hospitals on Epic • Expansion and standardization of clinical education drove efficiencies and improved competency of the team allow- ing them to serve more patients • Number of patients served grew by over 5,600 cases across both states • In 2020, our care management penetration into the MSSP population increased over 10 percent compared to 2019, touching 10 per- cent of the entire MSSP population in IL and almost 13 percent of the MSSP population in Wisconsin • Expansion of our Advanced Care at Home Program, which includes Hospital at Home and Palliative Care”

Gary Stuck, D.O.

And it quoted Gary Stuck, D.O., the health system’s chief medical officer. “Once again, we have shown ourselves to be a national leader in value-based care,” Chief Medical Officer Dr. Stuck said. “I

couldn’t be more proud of our resilient team and their focus on this important work.” The press release noted that “MSSP ACOs are offered financial incentives to both improve quality and reduce health spending. When an ACO – a group of doctors, hospitals and other providers that form networks to coordinate patient care


– demonstrates that it has achieved certain quality and cost reduction benchmarks, it is rewarded with a share in the savings generated for Medicare.” It also noted that “Advocate Aurora’s

three ACOs combined received $56 million back from the program, savings that are re- invested in patient care. Advocate Aurora’s three affiliated ACOs span both the states it serves, with Advocate Physician Partners Accountable Care, Inc. managing 113,033 Medicare beneficiaries in Illinois and Accountable Care Organization of Aurora, LLC and Aurora Accountable Care Organization, LLC managing 47,871and 23,727 Medicare beneficiaries, respectively, in Wisconsin.”

The Advocate Aurora integrated health system overall encompasses 26 hospitals, 500-plus sites of care, 10,000 physicians, and 75,000 team members, and earned $12 billion in revenues last year. The system was created in 2018 as the result of a merger between two existing systems, Advocate in the Chicago area and northeast Illinois, and Aurora in the Milwaukee area and across the eastern portion of Wisconsin. Shortly after the announcement of the MSSP results, Dr. Stuck spoke with Healthcare Innovation Editor-in-Chief Mark Hagland regarding the advances that the health system’s ACO leaders have achieved, and his perspectives on the future of the organization’s ACOs and of the ACO phenomenon more generally. Dr. Stuck practiced clinically for 32 years; currently, all his energies are focused on executive leadership in the organization. Below are excerpts from that interview.

How do you account for your organization’s success in the MSSP? It continues to be challenging to achieve success in the program, doesn’t it? Thanks for recognizing how difficult it is. In the Chicago market, even some great

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