$2.1 Million in Savings with Improved Care and Quality

Published On: March 28, 2019

It’s hard to argue with $2.1 million in savings. Since ACO Partner connected to and began to receive data from Health Current just over two years ago, that is the amount of savings in managing a patient population of approximately 58,000, after the costs of their services are subtracted. Although ACO is in their name, ACO Partner is not an ACO, rather it is a services organization that supports providers with value-based healthcare.  ACO Partner currently has a network of over 1,100 physicians and advanced practitioners in Arizona.

A joint venture of Trinnovate Ventures and Change Healthcare, ACO Partner aims to help independent providers stay independent by offering services to assist primarily small practices meet the goals of improved quality and efficiency and enhanced patient experience and satisfaction. They help providers meet these goals by providing care coordination services as well as assistance with data analytics and technology to help drive the savings for successful participation in value-based contracts. Blue Cross Blue Shield of Arizona is ACO Partner’s first customer.

ACO Partner receives daily batch Alerts from Health Current on all their patients. Every day, their analytics team takes the Health Current information along with other analytics and provides an internal report which provides assignments to specific care coordinators who reach out to patients. Recently, they began integrating daily Health Current batch Alerts into their new care coordination software system.

“Independent physicians want to be good at value-based healthcare, but they need help. What we have been able to do on behalf of physicians is leverage risk scoring, risk stratification and provide a dedicated team of care coordinators who engage with the patient.”

 – Andrew JP Carroll, MD, FAAFP, Chief Medical Officer, ACO Partners

The key, according to Karen Bomersbach, Vice President of Operations and Finance, is to provide services and outreach to patients on behalf of providers so you’re not viewed as an outside or third party but as an integral part of the physician’s practice. Plus, it is also important to have good data and specific targets for improving care coordination. “A lot of payers have gone the path of providing a PMPM, or per member/per month, incentive to physicians as a value-based incentive but this model delivers direct resources to the providers in the form of a care coordination team and data analytics to enable the physicians to improve the patient experience, improve quality, and improve efficiencies in the delivery of care and successfully participate in their value-based contracts.”

ACO Partner provides population health analytics for patient populations and risk scoring on individual patients to develop care plans that that are used along with data from Health Current to engage with patients on behalf of practices. The cost of these services is spread across all practices that are served, and this is they key to helping independent practices, according to Dr. Andrew Carroll, Chief Medical Officer. Dr. Carroll’s perspective comes from his own experience in private practice. “I tried to buy and use population health software, but the return on investment was negative,” he said. Independent physicians want to be good at value-based healthcare, but they need help. What we have been able to do on behalf of physicians is leverage risk scoring, risk stratification and provide a dedicated team of care coordinators who engage with the patient.

Andrew JP Carroll, MD, FAAFP, Chief Medical Officer, ACO Partners

Dr. Carroll cites one recent example of a patient who was going to a hospital emergency department or ED two to three times a week. They were able to engage the patient and direct the patient to a lower cost urgent care center when appropriate and reduce the patient’s need for urgent treatment overall. This is a good example of providing a patient “the right care in the right place at the right time,” according to Dr. Carroll. Most importantly, the patients really appreciate it, Dr. Carroll added. ACO Partner has a myriad of examples of patients avoiding tertiary care with the assistance of care coordination from ACO Partner.

The success of their outreach is integrating good information into the workflow of the care coordination team, according to Christina Cadaret, Executive Director of Care Coordination. There are different workflows for patients discharged from hospital EDs and inpatients who are discharged. The care coordination team follows scheduled targets for follow-up with patients and uses the Health Current portal to pull discharge summaries that they forward to practices via encrypted messaging. The follow-up outreach aims to ensure that patients understand discharge instructions and their medications in order to avoid readmissions or return trips to a hospital ED. This assists practices in providing the transitional care visit, which studies prove reduces readmissions, morbidity and mortality

The information from Health Current is a critical part of the work of ACO Partner and highly valued. In the past, the type of information that is received from Health Current was only available from claims data which is 45 or more days old, according to Karen Bomersbach. The value of Health Current data, she said, is that it is very current and it also provides excellent statewide coverage since most hospitals in the state are supplying data to the HIE.

ACO Partner is actively talking with other payers about providing similar care coordination and analytics services since their model can be transferred to other health plans and groups of providers. With data and services from Health Current, ACO Partner offers an excellent model for helping many more independent providers improve care and quality while reducing costs.