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Duke Physician-Led Network Exceeds Quality Standards, Saves Medicare Millions

Duke’s savings represent the highest amount in the state among participating networks


Sarah Avery
Sarah Avery
919-724-5343 Email

DURHAM, N.C. – Duke Connected Care, the physician-led accountable care organization (ACO) formed by Duke Health to improve health outcomes and address the national challenge of rising healthcare costs, saved Medicare $21.1 million last year.  

Duke’s ACO, which also exceeded evidence-based quality standards, generated the most cost savings among North Carolina ACOs participating in the Medicare Shared Savings Program, an initiative of the Centers for Medicare & Medicaid Services (CMS). 

The savings at Duke counter findings from a three-year study published Sept. 20, 2018, in the New England Journal of Medicine, showing that hospital-integrated ACOs participating in the program, on average, did not produce savings. 

The federal ACO program is designed to encourage care coordination, community partnerships and delivery of preventive care services that help Medicare patients manage chronic illness and avoid unnecessary hospital visits. Each ACO’s participants agree to be paid or penalized based on their collective ability to meet Medicare’s cost and quality expectations for an assigned population of patients.

The Duke ACO’s participants include the health system and its three hospitals, Duke Primary Care, Private Diagnostic Clinic and independent community providers in a seven-county region around the greater Triangle. 

In 2017, Duke’s ACO cared for more than 50,000 assigned Medicare patients at 4 percent below CMS’s projected cost. It achieved favorable results in the delivery of recommended preventive services -- including the number of eligible patients receiving flu shots, mammograms and colonoscopies -- and demonstrated improved patient outcomes.

“Duke Connected Care's success demonstrates that Duke Health can partner with payers and its broader physician community and continue to deliver on its reputation for high-quality care -- but at an even lower cost,” said Devdutta Sangvai, M.D., associate chief medical officer for Duke University Health System and executive director of Duke Connected Care. “What I find exciting is that our Medicare results simply scratch the surface in terms of the impact we can have on health outcomes.” 

Last year, only 34 percent of the Medicare Shared Saving’s program ACOs generated cost savings and met Medicare’s quality standards. In North Carolina, six of 19 ACOs succeeded in that goal.

Kombiz Klein, D.O., an independent physician with Durham-based Triangle Community Physicians, said being part of Duke’s ACO affords his practice additional resources to care for complex patients and clinical support that enables him to focus on delivering care that will have the greatest impact on health outcomes.
“Participating in Duke’s ACO has allowed us to provide a better, more coordinated care experience for our patients.” Klein said. “We are excited to continue our partnership with Duke Health, an organization that shares our strong commitment to improving our community’s health.”

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