Allegiance Health Group’s 47 physicians believed patients in their community deserve access to evidence-based medicine, delivered by independent physicians. These dedicated doctors recognized the need to build specialty care services and tertiary level programs to deliver more personalized service while focusing on continuous improvement.
The Allegiance ACO needed a consolidated view of patient information across their network (hospital EHRs, practice EMRs, claims and lab systems) to understand how to be more cost-effective, while helping physicians improve the quality of care for their higher risk patients.
Leaders needed an easier way to identify subsets of patients that represented the greatest need for, and opportunity to benefit from a different approach to care.
Allegiance ACO partnered with myCareGPS to identify patients with higher risk scores, higher costs and an increased likelihood of hospital admissions and emergency department visits. By identifying the 5% of patients that consumed nearly 35% of the resources, providers could effectively target care coordination activities. The system also provided analysis to support contract negotiations with commercial payers, skilled nursing facilities, hospices, and home care agencies.
BY THE NUMBERS
After 18 months of implementation, SNF costs were down 33% per assigned beneficiary and continue to hold steady
ER visits dropped 8% in 2015
ER visits leading to hospitalizations were down by 16% in 2015 and another 10% in 2016
Total inpatient costs decreased by 6.25% in 2015 and an additional 7% in 2016, with short-term hospital stay costs per assigned beneficiary down by 65% in 2015 and a further 10% in 2016
To better manage patient population and earn shared savings dollars though our Accountable Care Organization (ACO) contract.
The physicians of Shore Quality Partners Network used multiple EHRs. A complete view of clinical, financial and operational data was very labor intensive undertaking. Shore needed a more robust analytics platform so that its people could spend less time collating data
and more time identifying care gaps, analyzing costs, improving patient outcomes and making strategic decisions with comprehensive information.
Shore partnered with myCareGPS to centralize data from myriad systems, and use population health management software to identify and engage high-risk patients in clinical best practices — devoting appropriate resources and driving better outcomes.
BY THE NUMBERS
Generated $4.69 Million in shared savings payments across 16,000 patients in 2016
Outperformed geographic comparison group by $27.97 per member per month (equivalent of $5.37 million)
Decreased spending by high-ED-utilization patients by $1,600 per member per month
Maintained a 90th percentile ranking nationwide in patient satisfaction measures