Performance Highlights from the National Rural Accountable Care Consortium

Between 2015 and 2019, the National Rural Accountable Care Consortium’s (NRACC) Practice Transformation Network (PTN) worked with more than 8,000 clinicians and exceeded program commitments to Centers for Medicare and Medicaid Services (CMS). We used the Plan-Do-Study-Act model to teach practices to utilize nurse-led annual wellness visits, to establish a compliant chronic care management program and we teach proper quality-data monitoring and reporting techniques. Under NRACC’s guidance, our practices have collectively more than tripled the number of patients enrolled in chronic care (from 1.5% of patients enrolled at baseline to 4.9%) and increased annual wellness visit rates by 42%. Thanks to NRACC’s practice interventions, our enrolled clinics have:

• prevented 9,270 avoidable hospitalizations, or 747% of our CMS program goal;
• accrued $270 million in health care cost savings for CMS via NRACC initiatives, 144% of program goal;
• avoided 1,937 unnecessary test and procedures, 335% of the program goal; and
• improved health outcomes on key quality measures for 116,537 patients, 328% of program goal.

NRACC also ranks among the top Practice Transformation Networks for having supported clinicians move into Alternative Payment Models (APMs). We assisted more than 6,100 clinicians move to APMs. This success extends to rural; 757 of 1033 of our previously-enrolled brick-and-mortar rural practice locations have graduated to APM participation. 

NRACC has enjoyed demonstratable success in helping clients to increase their Quality Payment Program Scores for the Merit Based Incentive Payment System; our average scores were 5.2% point above the national average in performance year 2018 and our clients’ median scores were 7.7% above the national average.

Who is the National Rural Accountable Care Consortium?

A pioneering group of rural physicians and hospital administrators came together in 2013 to begin the journey toward managing rural population health. Through innovation and collaboration, they sought to transform today's rural healthcare delivery system into a world-class primary care system that provides professional satisfaction for clinicians, attracts consumers, and provides high-quality acute, post-acute and outpatient services that meet patients’ needs.

These rural thought-leaders joined forces to form the first National Rural ACO (NRACO) and create the NRACO Services Corporation (NSC), which has been supporting rural Medicare ACOs with training, data, analytics, patient satisfaction surveys, and evidence-based medicine programs since 2014. In 2015, NSC organized more than 6,000 providers in 159 rural health systems into 23 Medicare Shared Savings Program (MSSP) ACOs, and obtained $46 million in ACO Investment Model funding to support their ACO operations and local care coordination programs.  This group includes 55 rural PPS hospitals, 92 Critical Access Hospitals, 168 Rural Health Clinics, and 39 rural FQHCs serving more than 500,000 Medicare patients.

Working with other key stakeholders like the National Rural Health Association and the National Rural Health Resource Center, the rural hospital CEOs also started the non-profit National Rural Accountable Care Consortium. The Consortium will assist hundreds of rural health systems in their journey toward accountable care, funded by a $31 million cooperative agreement award from the Center for Medicare and Medicaid Innovation (CMMI). 

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