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Apollo Medical Holdings, Inc. Announces APA ACO Achieved $48.8 Million in Shared Savings from Centers for Medicare and Medicaid Services for 2021 Performance Year
Apollo Medical Holdings, Inc. ("ApolloMed," and together with its subsidiaries and affiliated entities, the "Company") (NASDAQ: AMEH), a leading physician-centric, technology-powered healthcare company focused on enabling providers in the successful delivery of value-based care, today announced that its wholly-owned subsidiary, APA ACO, Inc. ("APA ACO") generated $56.2 million in gross savings for the 2021 performance year, resulting in $48.8 million in shared savings from the Centers for Medicare & Medicaid Services ("CMS").
In 2016, APA ACO applied for and was approved by CMS to participate in the Next Generation Accountable Care Organization (ACO) Model. APA ACO was approved to participate in the All-Inclusive Population-Based Payment ("AIPBP") track, which was the most advanced risk-taking payment model. Under the AIPBP track, CMS estimates the total annual expenditures for the Next Generation ACO`s patients and then pays that projected amount to the ACO in a per-beneficiary, per-month ("PBPM") payment. The Next Generation ACO is then responsible for paying all Part A and Part B costs for in-network participating providers and preferred providers with whom it has contracted. In the program, APA ACO took on the risk for all of Medicare Part A and Part B for contracted and participating providers, meaning that APA ACO worked hand-in-hand with its providers to manage their patient population.
For 2021, APA ACO`s aggregate benchmark expenditure was $437.2 million, with actual expenditures amounting to $381.1 million, resulting in gross savings of $56.2 million. The Company elected the 80/20 risk arrangement with CMS in 2021, the Next Generation ACO`s final performance year, which allowed APA ACO to retain 15% of its gross shared savings, or $48.8 million.
Brandon Sim, Co-Chief Executive Officer of ApolloMed, stated, "We are proud that our ACO generated $56.2 million in gross savings, the highest nationwide in both gross savings amount and in savings percentage, as part of our participation in the Next Generation ACO program during the 2021 performance year. We truly believe that our continued ability to deliver leading results in healthcare delivery for Original Medicare patients across the country is validation of ApolloMed`s physician-centric, tech-enabled, value-based care model. This is, at its core, a superior level of care coordination and population health management that allows our providers to deliver high-quality care at lower costs."
As 2021 was the final performance year of the Next Generation ACO program, APA ACO transitioned to the Global and Professional Direct Contracting ("GPDC") program and began participating as a Direct Contracting Entity in the 2022 performance year, beginning January 1, 2022.
ApolloMed is a leading physician-centric, technology-powered, risk-bearing healthcare management company. Leveraging its proprietary end-to-end technology solutions, ApolloMed operates an integrated healthcare delivery platform that enables providers to successfully participate in value-based care arrangements, thus empowering them to deliver high quality care to patients in a cost-effective manner.
Headquartered in Alhambra, California, ApolloMed`s subsidiaries and affiliates include management services organizations (MSOs), affiliated independent practice associations (IPAs), and entities participating in the Centers for Medicare & Medicaid Services Innovation Center (CMMI) innovation models.