eBrightHealth ACO Waiver Protection Form
Shared Savings Distribution
Type of Waiver Utilized:
Shared Savings Distribution Waiver
All Parties Involved:
ChristianaCare Health Services, Inc.
Christiana Care Quality Partners Accountable Care Organization (CCQP ACO dba eBrightHealth ACO) All ACO Participants
Date Program will begin:
January 1, 2016 with revisions effective January 1, 2022
Description of Arrangement:
The Centers for Medicare and Medicaid Services (CMS or Medicare) measures the performance of Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program on an annual basis referred to as a performance year. At the end of each performance year, CMS will calculate the cost of care for those Medicare beneficiaries assigned to Christiana Care Quality Partners ACO, LLC dba eBrightHealth ACO. This calculated cost will be compared to established spending targets. The goal of an ACO is to reduce unnecessary healthcare cost through proactive and preventive patient care. CMS will also determine whether eBrightHealth ACO has met the quality reporting and performance standards for that particular performance year.
If an ACO meets or exceeds Medicare’s performance standards for both the cost and quality measurements, it may be entitled to receive Shared Savings. Shared Savings is a portion of the dollars saved by instituting cost-reduction initiatives while demonstrating high quality patient care. The exact amount/percentage of Shared Savings that is awarded depends on how well the ACO meets or exceeds Medicare’s standards for performance.
If eBrightHealth ACO receives Shared Savings from CMS for a particular performance year, eBrightHealth ACO will determine Shared Savings for each ACO Participant based on each ACO Participant’s specific performance on the quality measures and the number of attributed Medicare beneficiaries for whom they provided primary care during the performance year as per the eBrightHealth ACO Shared Savings/Losses Distribution policy.
Purpose of Arrangement:
An ACO provides an opportunity for Medicare beneficiaries to receive high quality evidence-based health care that eliminates waste and reduces excessive costs through improved care delivery. The distribution of Shared Savings is designed to incent providers to incorporate quality improvement and the reduction of unnecessary cost into their practice.
Items, services, facilities or goods covered by the arrangement:
Shared Savings Incentive Payments as outlined in Description of Arrangement.
Date and manner of the Governing Body’s Authorization:
Approved by the Board of Managers on 7/29/2015 with 1/1/2022 revisions approved by Board of Managers on 9/16/2021.