Tag Archive: ACOs

A Nice Note from our Chief Medical Officer about Data and Care Coordination:

We had a very productive telephone meeting regarding one of our member’s patient care opportunities this morning. The combination of Lightbeam’s data and the ability to collate with the EMR data really illuminated some opportunities for care coordination. Everyone was motivated to work together. Drilling down on individual patients locally, especially the high utilizers, is invaluable.

The two specific patient cases were interesting in that they were both very sick patients, but had very different healthcare barriers:

Patient 1. An end-of-life patient who had multiple admissions, but only 3 visits to her primary care provider.

This patient would have likely benefited from some care coordination between the discharge Planner at the hospital and the outpatient Care Coordinator to facilitate better follow-up with their PCP. This may have led to more in-depth discussions about end of life, Hospice, etc. Even if the patient or family was not interested in palliative care, it would have at least allowed for closer follow-up between hospitalizations for preventative care, medication compliance or dosing adjustments, etc. All of which could have improved the stability of this patient’s health and comfort in the months leading up to her death.

The other patient was very different, but also very sick.

Patient 2.  A chronic disease patient (COPD) who had seen multiple physicians, but was, nonetheless, admitted 8 times for COPD in the first 9 months of 2014.

The opportunities for care coordination here are certainly different, but equally important and achievable. The outpatient chart review was interesting: showing yet another admission since data collection in the spreadsheet. In this subsequent admission, the patient refused follow-up in the 3 days of respiratory worsening leading up to admission. The opportunity for a Care Coordinator to be collating all the discharge information, specialist care/recommendations, communicating with the patient and PCP with the goal of breaking down barriers to outpatient care access or novel methods for and outpatient action plan (ie corticosteroids) or redirecting care away from the ER when appropriate are obvious.

There seem to be many windows of opportunity that were identified and taking the Lightbeam data back to the Care Coordinators, hospital discharge planners and associated PCPs at the local level seems to be an actionable way to improve the patients’ care and also decrease costs.
Paul Krause, MD
Chief Medical Officer

Rural ACO Summit Set for February 2, 2015 in Washington, DC

Fifty-nine Critical Access Hospitals joined ACOs in order to participate in the Medicare Shared Savings Program in 2014. This number will more than double in 2015, representing more than 10% of all CAHs. CMS is providing $114 million in grant funds for up to 300 rural health systems to join the program in 2016. The National Rural ACO is hosting a free educational conference at the Capitol Hilton in Washington, DC on Monday, February 2nd, 2015; the day before the National Rural Health Association’s Policy Institute. Visit www.ruralaco.com to learn more about the conference.

The Rural ACO Summit, sponsored by the National Rural Health Association and the National Rural Accountable Care Organization, will bring together experienced 2012-2014 rural ACOs, new 2015 rural ACO participants and potential applicants for the 2016 Program. Participants will learn the basics of ACO participation — including positive and negative effects on budgets, staffing, billing, and utilization. They will learn about policy issues that must be addressed to fix unique rural issues and the benefits of the ACO program, including important waivers and full access to claims data for your patients.

Who Should Attend?

New or existing ACO participants will not want to miss this opportunity to hear the latest from CMS and the experts in Washington while meeting with other ACO members from across the country looking to share information.

Prospective ACO applicants should attend to gain valuable first-hand knowledge from early adopters and recognized experts in the program. It will be a fantastic opportunity to determine whether you can, or should, join an ACO.

Attendees will also learn how to qualify and apply for the exciting new ACO Investment Model Program, $114 million dollars already allocated by CMS which pre-pays qualifying applicants, providing the start-up capital to fund rural ACO participation.

CMS is at the table. Are you? We look forward to seeing you in Washington, DC!  Click here to register today. There is no cost to register.

Click here for more information about the Policy Institute.  We look forward to seeing you in Washington, DC on February 2, 2015.

Rural ACO Summit Set for February 2, 2015 in Washington, DC

Fifty-nine Critical Access Hospitals joined ACOs in order to participate in the Medicare Shared Savings Program in 2014. This number will more than double in 2015, representing more than 10% of all CAHs. CMS is providing $114 million in grant funds for up to 300 rural health systems to join the program in 2016. The National Rural ACO is hosting a free educational conference at the Capitol Hilton in Washington, DC on Monday, February 2nd, 2015; the day before the National Rural Health Association’s Policy Institute. Visit www.ruralaco.com to learn more about the conference.

The Rural ACO Summit, sponsored by the National Rural Health Association and the National Rural Accountable Care Organization, will bring together experienced 2012-2014 rural ACOs, new 2015 rural ACO participants and potential applicants for the 2016 Program. Participants will learn the basics of ACO participation — including positive and negative effects on budgets, staffing, billing, and utilization. They will learn about policy issues that must be addressed to fix unique rural issues and the benefits of the ACO program, including important waivers and full access to claims data for your patients.

Who Should Attend?

New or existing ACO participants will not want to miss this opportunity to hear the latest from CMS and the experts in Washington while meeting with other ACO members from across the country looking to share information.

Prospective ACO applicants should attend to gain valuable first-hand knowledge from early adopters and recognized experts in the program. It will be a fantastic opportunity to determine whether you can, or should, join an ACO.

Attendees will also learn how to qualify and apply for the exciting new ACO Investment Model Program, $114 million dollars already allocated by CMS which pre-pays qualifying applicants, providing the start-up capital to fund rural ACO participation.

CMS is at the table. Are you? We look forward to seeing you in Washington, DC!  Click here to register today. There is no cost to register.

Click here for more information about the Policy Institute.  We look forward to seeing you in Washington, DC on February 2, 2015.