Higher-Risk Medicare Shared Savings Program Pays Off for Some

Heartland Regional Medical Center had more to lose than most when it gambled and joined Medicare's experiment with accountable care in 2012. For the first year at least, that risky bet paid off. The St. Joseph, Mo., hospital owes Medicare nothing and instead will be awarded $2.9 million for its efforts.

Heartland Regional was one of four out of 114 organizations that opted for the riskier of two payment options under Medicare's broad test of accountable care, known as the Shared Savings Program, during its inaugural year. That choice meant that failure to curb medical expenses for Medicare patients under Heartland Regional's care would put the hospital at risk for potentially significant financial penalties. The hospital would be required to pay Medicare for a share of costs that exceeded set targets.

But with a willingness to risk losses, Heartland Regional also stood to earn bigger rewards. (The remaining 110 organizations agreed to smaller bonuses with no risk for loss.)

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Source: Modern Healthcare