Provider Insider

Leadership Message

Fall 2019 | Issue No. 7

Increasing Our Shared Savings


A word from our medical director, Dr. Austin Bailey.


Hello everyone. It’s that time of year when we learn about our collective performance in our value-based programs for the previous year, and whether we have achieved shared savings dollars to distribute to you. As we have been discussing in our monthly meetings at your practice, these shared savings pools have been diminishing in size over the past several years. Why? Cost!


To create a shared savings pool in a performance year, our trend for the population’s total cost of medical care—including pharmacy costs—must be lower than the cost trend for the payer’s Colorado market. Even though we succeeded in doing this in past years, it is getting harder to sustain that success.


Going forward, we will focus on several cost drivers that we believe we can most readily influence. This includes our continued focus on emergency department utilization. We will address pharmacy costs and implement some easy steps to help providers avoid unnecessary use of high-cost medications. We will focus more intensively on management of transitions of care from acute hospitalizations and emergency department visits. Continued analysis of the claims data will inevitably suggest other areas that we should address.


We will continue to support the excellent work that all of you are doing on quality metrics. Where shared savings pools have declined over time, your quality performance has continued to steadily improve. While this is most important for patients’ outcomes, higher quality scores also allow us to get more of any shared savings pool that we produce.


As always, overall success of the Network is dependent on the excellent work you do every day in your practices. We applaud your continued efforts toward improvement.