23AMGA.ORG APRIL 2019
Many physician groups and small practices have formed their own accountable care organizations (ACOs) to garner bonuses from the Medicare Shared Savings Program (MSSP). However, only
34% of the 472 ACOs in the MSSP earned shared savings
payments for 2017.1 ACOs that did not achieve savings
probably wonder why those organizations did so well:
Did they have a secret sauce?
I can’t speak for other ACOs, but the Rio Grande
Valley Health Alliance (RGVHA), the physician-led
ACO that I administer, has no secret sauce. We
simply use a proven, no-nonsense approach to pop-
ulation health management. As a result, we generated
MSSP bonuses five years in a row. In 2015, we saved Medi-
care $14.2 million, of which our providers received half. In
2016, our ACO’s first year in Track 3 of the MSSP, we
received 75% of the $8.5 million we saved. And in
2017, RGVHA generated $9.8 million in savings
and earned $6.8 million.
Most RGVHA providers practice in Hidalgo
County, Texas, where McAllen is the largest city.
Our population is heavily Hispanic, with an inci-
dence of end-stage renal disease and diabetes
far above the national averages. The patients
tend to be poor, and many are on Medicaid.
Cumulatively, our practices serve about 20,000
patients, with our MSSP ACO panel accounting
for roughly 7,500 beneficiaries.
Rio Grande Valley Health Alliance’s (RGVHA) ACO, which
includes 24 primary care physicians, achieved success
by following a few basic rules:
1 RGVHA hired four nurse care coordinators to care for and meet the needs of high-risk patients between visits.
2 RGVHA built strong physician support.
3 RGVHA used a robust population health management IT solution that provided the data and the analytics to help
physicians fill care gaps, understand utilization, and improve
Life in the Valley