Case Study: Monarch HealthCare achieves 6.3% Medicare Pioneer ACO shared savings with Optum360

Care coordination actionable analytics help Monarch HealthCare achieve Pioneer ACO shared savings

Monarch HealthCare, an Orange County, Calif. independent practice association and one of the original Medicare Pioneer ACOs, faced the challenge of applying its HMO-style care management to a fee-for-service Medicare population with higher chronic disease burden and different provider-choice expectations. To bridge that gap, Monarch partnered with Optum360 for advanced IT and analytics capabilities to extend its care coordination and population health management into the Medicare environment.

Optum360 supplied actionable analytics, historical claims data and tools that let Monarch identify high utilizers, target care-management programs, and analyze physician referral and treatment patterns to guide better, lower-cost care. With Optum360’s support, Monarch achieved measurable shared savings—cutting Medicare expected charges by 6.3% in the Pioneer ACO’s first year (the second-highest percentage among Pioneer ACOs)—demonstrating clear impact on cost and care coordination.

Monarch HealthCare

Jay Cohen

Executive Chairman