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How Does An ACO Reach Top Medicare Shared Savings?
How Does An ACO Reach Top Medicare Shared Savings?
Through TigerConnect, ICP Achieves Goals of Quality Care, Patient Safety, and Cost Savings
How do you get to be one of the nation’s top Accountable Care Organizations (ACO)? Out of 472 ACOs, Innovation Care Partners (ICP) ranked third in the country in terms of savings percentage and sixth in terms of shared savings return through Centers for Medicare & Medicaid Services’ (CMS’) Medicare Shared Savings Programs (MSSP). ICP achieved this success all during a period of rapid growth. The ACO opened its doors in 2012 with 1,500 covered lives and quickly grew to more than 100,000 covered lives and 1,800 physicians.
According to Faron Thompson, Chief Operating Officer at ICP, there are a number of different factors that go into how an ACO can achieve those kinds of results. “A lot of it really comes down to better communication and better coordination of care. And there are lots of different examples of how TigerConnect specifically helps us to support those goals.”
Accountable Care Organizations Defined
Accountable Care Organizations are groups of doctors, hospitals, and other healthcare providers, who voluntarily come together to give coordinated high-quality care to their Medicare patients. The goal of coordinated care is to ensure that patients get the right care at the right time, while preventing medical errors and avoiding unnecessary duplication of services. When an ACO succeeds in both delivering high-quality care and spending healthcare dollars more wisely, the ACO will share in the savings it achieves for the Medicare program.*
How ICP Care Teams Use TigerConnect to Facilitate Patient Safety
In the case of ICP’s use of TigerConnect, first and foremost physicians are better able to talk to each other about their patient care. In a Medicare population, you certainly have a lot of healthcare needs — a lot of chronic care patients, and a lot of patients that have multiple chronic conditions. That means most patients will have multiple physicians. One patient might have a primary care physician, an endocrinologist, a cardiologist, as well as other specialists as needed.
If all of those physicians can talk to each other asynchronously anytime they need to coordinate care, you avoid putting patients at risk who may have as many as 30 different medications. If physicians weren’t coordinating the care and managing medications and dosages properly, you could have some medications turn out to be contraindicated.
ICP caregivers also use TigerConnect to communicate real-time notifications to transition care managers. “If one of our patients shows up in an emergency room and registers in the lobby, our primary care physician, the specialists associated with that patient, and our transition care managers will get a real-time notification that we deliver through TigerConnect,” said Thompson.
How Better Communication and Care Coordination Helped ICP Achieve Cost Savings
For ICP, 2017 was their best year ever. They saved the federal government 16.9% of spend, which translates to approximately $19.5 million in shared savings. They were able to achieve these goals primarily by reducing readmission rates and costly emergency visits that weren’t necessary. This not only lowered healthcare costs, but it also improved the quality of care and the patient experience.
For example, if a patient is taken to a hospital emergency department within the ICP network, a transitional care manager (TCM) might go down and intercept the patient in the lobby before the patient is admitted. The TCM can conduct a short consult with the patient, communicate with the patient’s primary care physician or a specialist via TigerConnect, and possibly avoid an expensive emergency visit.
The TCM can then arrange for a primary care visit or a specialist visit the next day or even that same day for the patient and avoid $5,000 or $10,000 of care in the emergency room when the patient really doesn’t need to be there.
The ability to coordinate care for the patient beyond the confines of physical sites, specialists, and services – going wherever patients and providers are is critical to the success of an ACO. TigerConnect has been a big help to ICP in this area.
“We always want to make sure we keep the patient within our network,” said Karen Vanaskie, chief clinical officer at ICP. “TigerConnect helps us communicate better along the continuum of care so patients don’t divert.”
Specific Use Cases Implemented by ICP Leveraging TigerConnect
TigerConnect’s ability to transmit images and documents securely, as well as communicate through VoIP video and phone, has really helped ICP coordinate care and share information in real time. Some examples of how ICP is leveraging TigerConnect to provide higher quality care at lower costs include:
- Curbside consultations are often conducted by ICP transitional care managers (TCM), for example, a TCM might snap a quick photo of a patient’s rash to send to a Dermatologist
- Physicians often coordinate care through group text, video or phone conversations
- Pathologist are encouraged to obtain clarification and context through TigerConnect from the ordering physicians before performing biopsies
- Ancillary service departments often use TigerConnect to securely send images and documents such as lab results, EKGs, and X-Rays to a specialist for a patient consultation
- ICP transition care managers and case managers communicate with primary care physicians regarding ED and hospital admissions
- The patient-centric approach ICP practices allows for real-time patient status alerts to be automated and received by the entire care team
Tags: Medicare Shared Savings Programs, MSSP, ACO Medicare Shared Savings, Accountable Care Organizations, ACOs, Centers for Medicare & Medicaid Services, CMS, TigerConnect