Novant Health ACO Leads U.S. in Medicare Shared Savings Program Quality Scores

Physician Quality Partners LLC, Novant Health’s Coastal Regional Accountable Care Organization (ACO), achieved the highest quality score in the U.S. for 2024 under the Centers for Medicare and Medicaid Services’ (CMS) Medicare Shared Savings Program (MSSP). The MSSP evaluates ACOs on multiple quality metrics including management of chronic conditions like hypertension and high cholesterol, preventive screenings for cancer, flu vaccinations, and interventions for tobacco cessation and fall risk. Physician Quality Partners scored 98.69, maintaining the top rank for the second consecutive year among 480 nationwide ACOs, reflecting a strong commitment to preventive care and improved patient outcomes for their Medicare population exceeding 18,000 beneficiaries. The MSSP incentivizes healthcare systems to reduce costs while improving quality by projecting predicted spending for Medicare beneficiaries and sharing savings when actual costs come in lower. The Novant Health ACO’s success illustrates effective chronic disease management and preventive health strategies that not only align with federal cost-saving goals but also enhance patients’ health. Their approach includes addressing early detection of diseases such as breast cancer, which reduces need for invasive treatments and improves survival rates. Dr. Jeffrey Warhaftig, medical director for the Novant Health Coastal Region and Physician Quality Partners, emphasizes that the program’s primary focus is on preventive care to reduce negative health outcomes. The ACO’s integrated clinics standardize care across insured populations rather than differentiating by insurance status. This coordinated care model, sustained over a decade, relies heavily on patient engagement as an essential factor in achieving high-quality outcomes. This case highlights the evolving role of ACOs in the broader landscape of healthcare reform, particularly under value-based care models that prioritize efficiency and quality over volume. With CMS enhancing reimbursement structures tied to quality and cost-effectiveness, successful models like Novant Health’s ACO provide a replicable framework for other healthcare providers aiming to improve Medicare patient care while contributing to federal cost containment efforts. These findings have implications for payer/provider collaborations, regulatory compliance, and healthcare market strategies focused on advancing preventive care services. The ongoing performance monitoring by CMS underscores increased accountability for ACOs to meet standardized quality benchmarks, presenting both opportunities and challenges in maintaining high performance in population health management.