How Baycare Health Partners Turned Shared Savings into Lasting Community Impact

Key Takeaways

• Baycare Health Partners needed a sustainable way to invest in community health while navigating the complexities of risk-based contracts and improving documentation of patient illness burden.
• Partnering with Premier since 2012, Baycare leveraged tailored data analytics, regulatory guidance and collaborative learning to strengthen its approach to value-based care.
• Baycare has generated more than $48 million in Medicare shared savings and nearly $200 million across all value-based contracts over the last 13 years. As a result, this significantly improved chronic disease management metrics and the healthcare organization reinvested in initiatives like in-office retinal screening and home blood pressure monitoring to enhance care access and patient outcomes.

In 2012, Baycare Health Partners in Western Massachusetts made a pivotal shift. The physician-led organization chose to move away from fee-for-service models in favor of value-based care (VBC) — motivated not by mandates, but by a desire to improve care and invest directly in the community.

“We wanted to reinvest in our community,” said Dr. Richard Shuman, Chief Executive Officer of Baycare Health Partners. “VBC gave us a way to do meaningful work that improves lives.”

By focusing on whole-person care, understanding that outcomes are shaped just as much by social and behavioral factors as clinical care, Baycare set out to create a sustainable model that puts patient needs first.

A Model Built on Purpose

Baycare’s transition to VBC began with the Medicare Shared Savings Program (MSSP) and expanded to Medicaid and major commercial contracts. Today, roughly 90 percent of the organization’s patients are covered under advanced risk arrangements.

But adopting this model brought new challenges. Unlike fee-for-service, where payments follow quickly after services are rendered, VBC requires upfront investment, often without knowing the outcome for years.

“You make a decision, like investing in care management, because you believe it's the right move for patients,” said Shuman. “Outcomes may take time, and sometimes you have to refine your approach. That’s why patience and a long-term commitment to doing what's right are so important in value-based care.”

Baycare also had to overcome structural hurdles. In its early days, the organization operated under a messenger model, limiting its ability to negotiate contracts. Over time, transitioning to a clinically integrated network allowed Baycare to improve quality while also gaining more flexibility to advocate for fair rates on behalf of its providers.

A Trusted Partner in Premier

Since the beginning of its VBC journey, Baycare has worked alongside Premier to navigate complexity, respond to regulatory changes and evaluate strategic decisions. The relationship has been grounded in trust and mutual understanding.

“In my experience, what sets Premier apart is that the team really understands us,” said Shuman. “They don’t just share general insights; they take the time to tailor recommendations to Baycare and aren’t afraid to offer a perspective we might not have considered.”

That collaborative dynamic proved especially valuable when Baycare was exploring a potential third-party population health vendor. Premier provided detailed data analysis and thoughtful input that helped Baycare weigh its options and make an informed, long-term decision.

In other cases, Premier’s support has helped Baycare respond to national policy shifts, decode the Centers for Medicare & Medicaid Services (CMS) rule changes and apply data in ways that align with community needs.

Learning from Peers Through the Pop Health Management Collaborative

Baycare also draws valuable insights from its participation in Premier’s Population Health Management Collaborative, which connects provider organizations across the country to share strategies, actionable data and real-world experiences. Through in-person events and virtual forums, Baycare has exchanged best practices with peers on topics ranging from HCC coding to end-of-life care.

One particularly impactful session featured a discussion on improving end-of-life care. Inspired by what they heard, Baycare reached out to learn more, adopted new workflows and interventions, and saw measurable improvements in this area. “We were able to take what others were doing, adapt it for our population and move out of the bottom tier for those metrics,” said Shuman. “That kind of peer learning is invaluable.”

Moving the Needle with Data and Clinician Education

In 2021, Premier’s analytics surfaced an important area for improvement: Baycare wasn’t fully capturing the complexity of its patient population through clinical documentation. Leadership believed that the data didn’t reflect the true illness burden of those patients they served, putting the organization at a disadvantage when negotiating risk-adjusted budgets.

To solve this issue, Baycare worked with Premier’s advisory services team to create its own clinician education program to close the gap.

“Rolling it out wasn’t easy, getting providers engaged took some work,” said Shuman. “But once we tied it into our funds flow model and adapted based on their feedback, things really started to click.”

By the end of 2024, Baycare saw a significant improvement in its documentation performance and is now performing in the top tier among Premier ACOs for capturing illness burden, helping ensure budgets more accurately reflect patient needs.

Reinvesting in Improving the Health of Communities

Baycare’s investments in VBC have paid off. The organization has generated more than $48 million in Medicare shared savings and nearly $200 million across all value-based contracts over the last 13 years.

But those dollars are just one part of the story. “Our mission isn’t about savings,” said Shuman. “It’s about helping the sickest and most vulnerable people stay well and stay home.”

Baycare has reinvested its savings into programs that support early detection and better disease management. For example, the organization placed retinal screening machines in primary care offices, helping catch diabetic eye disease early and prevent vision loss. They also distributed home blood pressure cuffs to patients with hypertension—an initiative that significantly improved control rates and helped Baycare become one of the top-performing organizations in Massachusetts for both hypertension and diabetes management.

“These are the kinds of things that don’t get reimbursed under traditional models,” said Shuman. “But they matter. And in a value-based world, we can make them happen.”

Looking Ahead

Baycare’s future is focused on deepening and expanding what’s working: continuing provider education, exploring Medicare Advantage opportunities, and investing in smarter care models. Two key areas stand out: engaging advanced practice providers and adopting artificial intelligence (AI) tools to support population health.

“With 75 percent of our primary care expected to be delivered by nurse practitioners and physician assistants within five years, we know we need to support and engage that workforce,” said Shuman. “We’ve already brought half of the APPs in our region into Baycare, and we’re working to reach the rest.”

Baycare is also piloting AI-enabled technology to better predict which patients are at risk of hospitalization, readmission, or in need of palliative care, allowing the organization to intervene earlier and provide more personalized support.

Throughout these efforts, Baycare will continue to rely on Premier, not just as a vendor, but as a collaborative partner ready to guide the next phase of transformation.

“There are so many important decisions ahead,” said Shuman. “Whether it’s evaluating new models, responding to policy changes, or figuring out how to operationalize what’s next, having Premier in our corner helps us stay focused and make smarter moves. They’re part of our journey, every step of the way.”

For more:

• Learn how Premier's advisory experts can help your organization unlock efficiency and improve outcomes with a Healthcare Rapid Assessment.
• In 2023, members of Premier’s Population Health Mangement Collaborative earned over $302 million in performance payments and generated $620 million in Medicare savings. Discover how your organization can do the same.