LTC ACO Receives Positive Reconciliation and Settlement Under the Medicare Shared Savings Program (MSSP)

LTC ACO Receives Positive Reconciliation and Settlement Under the Medicare Shared Savings Program (MSSP)

KENNETT SQUARE, PA — LTC ACO, the first long-term care sponsored Accountable Care Organization (“ACO”) in the United States and a subsidiary of Genesis HealthCare (Genesis) (NYSE: GEN), recently received a positive reconciliation and settlement under the Medicare Shared Savings Program (“MSSP”) for the 2019 performance year and as a result, generated shared savings for the second consecutive year.

During 2019, the Company managed approximately 5,800 Medicare fee-for-service beneficiaries under the MSSP with annualized Medicare spend of more than $160 million. In 2019, the MSSP required the LTC ACO to save at least 2.8% of the total Medicare spend under management to share in up to 62.5% (50% applicable to the first half of the year and 75% for the second) of the savings with Centers for Medicare and Medicaid Services (CMS). In August 2020, CMS notified Genesis that it reached the minimum savings rate set by CMS required for gain share. As a result, in the third quarter of 2020, the LTC ACO will recognize MSSP shared savings of approximately $18.8 million and income of approximately $17.0 million net of participating provider distributions.

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“With more than four years of participation under the MSSP, we have gained valuable experience driving better outcomes and improved quality, managing episodic cost and developing in-house capabilities to predict program performance,” notes Jason Feuerman, President of LTC ACO. “In fact, we generated an approximate 19.6% savings rate on costs under management and a 94.5% quality score in the 2019 MSSP performance year. These scores and quality outcomes reflect the benefits of our collaboration with dedicated Genesis Physician Services (GPS) physicians and advance practice providers as well as improved alignment and collaboration with other participating physicians, creating an environment to achieve these goals. This alignment is something that has rarely been accomplished heretofore in the long-term care industry.”

Now contracted with more than 200 non-Genesis affiliated long-term care facilities and physicians nationally, LTC ACO is well positioned to improve quality and create a newly aligned shared savings revenue opportunity for both those serving long-term care residents.

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Going forward, LTC ACO plans to continue to bring its expertise to non-Genesis long-term care facilities and clinical providers over the coming year. Participation in the LTC ACO can be significantly expanded more broadly throughout the long-term care industry due to its track record of positive patient outcomes as well as positive financial results.

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