Faculty Group Practice Newsletter

We're excited to share important news regarding a significant collaboration set to enhance healthcare delivery and value. Effective January 1, 2026, The University of Texas Medical Branch (UTMB) will be joining The University of Texas Health Science Center San Antonio (UTHSCSA) in a merged Accountable Care Organization (ACO) relationship. This new partnership will participate in the Centers for Medicare and Medicaid Services' (CMS) Medicare Shared Savings Program (MSSP).

This strategic alliance brings together two leading institutions with a shared commitment to improving patient outcomes and managing healthcare costs more effectively. An ACO is a group of doctors, hospitals, and other healthcare providers who come together voluntarily to give coordinated high-quality care to their Medicare patients. The goal is to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

Success within an ACO, particularly in a program like MSSP, hinges on several critical levers:

• Risk Coding: Accurate and comprehensive risk coding is fundamental. It involves meticulously documenting all patient diagnoses to reflect the true complexity and health status of our patient population. This isn't just about reimbursement; it's about ensuring that our patients' acuity is correctly represented, which in turn helps us allocate resources appropriately and measure our performance against a properly risk-adjusted benchmark. Precise risk coding allows us to understand the burden of illness within our patient panel and demonstrate the value of the care we provide.
• Cost Containment: Effectively managing healthcare expenditures without compromising quality is another cornerstone of ACO success. This involves a multi-faceted approach, including:
• Care Coordination: Streamlining transitions of care, reducing avoidable hospital readmissions, and ensuring patients receive care in the most appropriate setting.
• Preventive Care: Emphasizing wellness and preventive services to keep patients healthier and reduce the need for more intensive interventions down the line.
• Efficient Resource Utilization: Optimizing the use of diagnostic tests, specialty referrals, and medications.
• Population Health Management: Proactively identifying and managing high-risk patients to prevent exacerbations and improve chronic disease management.

By focusing on these key areas, our combined ACO will be well-positioned to deliver high-quality, patient-centered care while achieving the shared savings goals of the MSSP. This collaboration represents a significant step forward in our mission to serve our communities and advance healthcare excellence. We look forward to the positive impact this partnership will have on our patients and our institutions.