Currently Viewing:
National Association of ACOs Fall 2018
Stephen Nuckolls: ACOs Remain the Government's Best Option to Control Healthcare Costs
November 25, 2018
Allison Brennan Discusses Impacts of Certain Proposed Changes to the MSSP
November 24, 2018
Dr Joe Antos Dissects the Challenge of Addressing Drug Prices
November 23, 2018
Dr Rob Fields Highlights Areas for Continued Innovation With ACOs
November 17, 2018
Allison Brennan Outlines the Greatest Challenges of the Proposed MSSP Changes
November 11, 2018
Stephen Nuckolls Discusses What May Change Under the Proposed Pathways to Success
November 10, 2018
Dr Katherine Schneider: MSSP Proposed Changes Will Be a Step Back on Path to Value
November 07, 2018
Dr Joe Antos: Attention Needs to Be on the Future Sustainability of Medicare
November 03, 2018
Dr Clif Gaus Discusses Measuring MSSP ACOs Savings
October 31, 2018
Dr Rob Fields: Proposed MSSP Changes Likely to Stifle ACO Movement, Increase Consolidation
October 30, 2018
Allison Brennan Highlights Areas of Opportunity With Proposed MSSP Changes
October 28, 2018
Dr Katherine Schneider Highlights How Proposed MSSP Changes Build Stability Into Program
October 27, 2018
Stephen Nuckolls Outlines His Greatest Challenges and Opportunities of the Proposed MSSP Changes
October 22, 2018
Dr Rob Fields Discusses Why More ACOs Might Turn to Medicare Advantage
October 21, 2018
Dr Joe Antos: Proposed MSSP Changes Not a Major Shift in Policy for ACOs
October 18, 2018
Allison Brennan: Trump's Administration Is Encouraging Risk, but Possibly Too Quickly
October 16, 2018
Dr Clif Gaus: Private Payer Engagement in ACOs Is Up
October 15, 2018
Stephen Nuckolls: 2 Years Isn't Enough Time for an ACO to Take on Risk
October 14, 2018
Dr Katherine Schneider on Handling Variability in ACO Contracts
October 10, 2018
Are Commercial Payers Experiencing Success With ACO Partnerships?
October 08, 2018
Predictability and Simplicity Needed to Help ACOs Take on Risk, Panelists Say at NAACOS
October 08, 2018
Dr Rob Fields Discusses How the Proposed MSSP Changes Impact Decisions Around ACOs
October 08, 2018
Dr Clif Gaus Highlights Excitement and Anxiety at NAACOS Fall 2018 Meeting
October 06, 2018
Tying Social Determinants of ACO Patients With High-Need, High-Cost Care
October 05, 2018
Currently Reading
Innovative Strategies Can Boost ACO Provider Engagement, Performance
October 05, 2018

Innovative Strategies Can Boost ACO Provider Engagement, Performance

Surabhi Dangi-Garimella, PhD
At the National Association of ACOs Fall 2018 conference, being held October 3-5 in Washington, DC, panelists shared successful innovative initiatives that have been developed by their accountable care organizations (ACOs). What worked and what did not was the focus of the conversation led by Debbie Welle-Powell, chief population health officer, Essentia Health.
At the National Association of ACOs (NAACOS) Fall 2018 conference, being held October 3-5 in Washington, DC, panelists shared successful innovative initiatives that have been developed by their accountable care organizations (ACOs). What worked and what did not was the focus of the conversation led by Debbie Welle-Powell, chief population health officer, Essentia Health.

Participants included Melissa Arana, MSN, RN, CMSRN, director of quality improvement, Baylor Scott and White Health; Amanda Gerlach, JD, MPA as executive director, Mission Health Partners (MHP); and Beth Souder, director of post-acute network, Delaware Valley ACO (DVACO). All 3 organizations are winners of NAACOS’ call for ACO innovations.

Baylor Scott and White
Baylor Scott and White Quality Alliance (BSWQA)’s ACO, which includes more than 6000 providers spread across 50 hospitals and 95 postacute care facilities, has also signed 13 to 14 value-based contracts with both commercial and Medicare payers, Arana said and added that provider performance on predefined quality measurements drives their compensation distribution model.

She shared a process map with the audience to show how BSWQA identifies care gaps in workflows and then develops interventions to cover these gaps.

“Interdepartmental groups came together to understand why providers weren’t meeting quality requirements and developed a fishbone diagram,” according to Arana.  “The highest bucket of care to focus on was identified through a prioritization tool,” which included issues with such as lack of direction on goals and accountability, lack of organizational arrangement, and multiple measures, lag time in reports, and lack of standardized internal reports among many others.

She then presented 4 of the innovative solutions that were a part of their wining submission:

1. Network utilization: Because providers were unable to identify BSWQA patients to keep them in-network, 3 interventions were proposed:
  • Network utilization education was disseminated to providers who were below a particular threshold. “Thresholds are set when we develop goals; if you don’t meet them, you shouldn’t participate,” Arana said.
  • Providers were educated around ACO-BSWQA patient identification
  • A provider search tool was added to all provider dashboards to allow patient identification: a drop-down menu allowed them to look at provider network for ease of reference. This improve patient care coordination.
The impact of this intervention was increased network utilization from 54.6% to 56.8% between 2016 and 2017.

“We are sustaining this by our Network Teams following up with the providers who are below a particular threshold on a quarterly basis.”

2. Focus measures creation: Presence of multiple quality contract measures led to lack of focus in physician efforts, which ultimately affected provider performance. The 3-pronged intervention included:
  • Identifying the most common measures across various payer contracts to develop focus measures. “We drilled down into [electronic health records] to understand workflows in provider offices,” she said.
  • Focus measure goals and thresholds were developed and implemented in May 2017
  • Finally, the focus measure action plan was implemented
A drastic reduction in quality measures was observed, from 63 down to 8, which in turn improved performance on the metrics.

3.Internal gap report creation: Duplication of efforts due to multiple reports being developed to identify gaps.
  • The analytics team at BSWQA developed standardized care gap reports
  • These reports were utilized for patient reach outs and the gap closure process was revised 

4. ​​​​Provider dashboard enhancement: Limited patient-level performance information with providers and care gaps. To improve on this:
  • Provider dashboards were updated to include focus measures, including provider’s performance, patient-level data for each care gap, and links to resources to improve performance
  • Include provider and practice-level reviews in newsletters.
Provider logins saw a 4-fold increase, from 9284 in 2016 to 37,906 in 2017.

“Provider education on this front continues and the dashboard is being enhanced over time,” Arana said.

Coming full circle, provider performance showed definite improvement. “The overall provider quality performance was 58.1% between October 1, 2017, and March 30, 2018, exceeding the goal of 52%,” according to Arana.

Their value-based care model is patient-focused and includes preventive services, as well as management of chronic illness and more adolescent well-care visits, screening for patients with diabetes, preventive cancer screenings, and more.

“Our total gross performance-based savings were $46.4 million, employers saved $22.7 million, and total performance revenue was $25.7 million,” Arana concluded.


 
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