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Aggregate Amount of Shared Savings/Losses

Aggregate Amount of Shared Savings/Losses

  • Performance Year 1: TBD
  • Performance Year 2: TBD
  • Performance Year 3: TBD

How Shared Savings Are Distributed

  • Any savings in actual cost over projected cost is shared with NewHealth Collaborative participants based on their ability to impact associated costs.
  • Unpaid surplus will be re-invested in NewHealth Collaborative’s infrastructure.
  • The available surplus dollars (if any) in each budget pool category will be distributed to NewHealth Collaborative participants in the following proportions:

Budget Pools

Total

PCP

Specialist

Hospital

Allocation Method

 

Outpatient Pharmacy (1)

  • Retail prescriptions for insured patients

N/A

N/A

N/A

N/A

Outpatient Ancillary

  • Home Health
  • DME
  • Ambulance and other Transportation
  • Prosthetics
  • Supplies
  • Other Ancillaries

100%

35%

35%

30%

Hospital, SNF, and Inpatient Rehab

100%

33%

33%

33%

Outpatient Services (excludes Diagnostics)

  • Ambulatory Surgery
  • Outpatient Emergency Room
  • Radiation Therapy
  • Physical Therapy
  • Occupational Therapy
  • Speech Therapy
  • Outpatient Rehabilitation
  • Other Outpatient Services

100%

35%

35%

30%

Outpatient Diagnostics

  • Imaging
  • Laboratory
  • Pathology
  • Other Diagnostics

100%

50%

50%

N/A

 

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