Miami Value-Based Healthcare Company Earns Recognition From Centers For Medicare And Medicaid Services For Exceptional Care Quality
MIAMI, FL – November 18, 2021 – Genuine Health Group, a Miami-based healthcare company focused on transitioning physicians to value-based care models, announced its accountable care organization, Genuine Health ACO, saved the Medicare system $11.6 million in 2020. The savings have been confirmed by the Centers for Medicare and Medicaid Services (CMS) and underscore the company’s continued success in improving health outcomes while reducing unnecessary medical expenditures. The savings also demonstrate Genuine Health’s rapid growth as measured by the number of physicians affiliated with the company and the total number of Medicare beneficiaries for whom Genuine Health manages care delivery.
Genuine Health ACO’s $11.6 million in savings represents the difference between how much Medicare anticipated spending on healthcare for the Medicare beneficiaries aligned with its ACO and how much the company actually spent. The anticipated amount is adjusted for patients’ age and health circumstances.
At its most basic level, the $11.6 million in savings means Medicare beneficiaries aligned with Genuine Health ACO required less hospital care than similar populations enrolled in traditional Medicare. And fewer hospitalizations are the result of a company-wide, disciplined approach to disease prevention, care access, and medication adherence: the foundation of Genuine Health Group’s approach to value-based care.
“We know what it takes to keep patients healthy and out of the hospital,” said Genuine Health Group’s CEO, Joe Caruncho. “The $11.6 million in savings we achieved is proof-positive that our model works. It’s also a testament to the high-performing physicians that have joined Genuine Health to bring about positive change in the way we care for people on Medicare.”
Genuine Health Group’s latest enterprise, Genuine Health Direct, will continue to advance care delivery aimed squarely at better health outcomes, reducing unnecessary healthcare expenses, and keeping patients healthy. In fact, as a Direct Contracting Entity, or DCE, Genuine Health Direct, which the company launched earlier this year, operates under a “mandate” from CMS to drive down healthcare expenditures, improve health outcomes, and increase health options for Medicare beneficiaries. However, unlike its ACO, Genuine Health Direct keeps 100% of the savings it earns for the Medicare system. In addition, as a DCE, Genuine Health Direct can pay monthly capitation payments to its participating physicians for providing care to their patients with traditional fee-for-service Medicare. Plus, they can earn bonuses for the savings they deliver to Medicare.
“We’re at a defining moment in our evolution,” said chief medical officer and Genuine Health Group co-founder, Dr. Orlando Fernandez-Lopez. “We have proven the power of technology-enabled healthcare delivery as a tool to reduce cost and improve health. Now, we anticipate a dramatic growth surge as we expand our model into new markets here in Florida and elsewhere.”
In addition to nearly tripling its savings over the previous year from $4 million to $11.6 million, Genuine Health ACO achieved a top quality score of 96.87%. The high quality score is based on physicians’ performance as well as Genuine Health’s support programs such as home health visits for patients leaving the hospital, and robust care for patients with chronic conditions, including those with diabetes, congestive heart failure, and COPD.
This year, Genuine Health Group received additional recognitions, including an “Excellence in Healthcare” award for CEO Joe Caruncho from South Florida Business & Wealth and a place on South Florida Business Journal’s “Fast 50” list, which recognizes the fastest-growing companies in South Florida. Genuine Health Group will be featured as one of the “Hispanic-Owned Businesses” highlighted by the South Florida Business Journal.
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The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.
About Genuine Health Group
Genuine Health Group is an analytics-driven healthcare company that assists physicians and health plans in successfully transitioning to value-based payment models.