Toward the end of last year, as providers dealt with varying degrees of the COVID-19 pandemic, CMS concluded that value-based care was outperforming fee-for-service. Recently, Caravan CEO, Tim Gronniger commented that, “ACO strategies are working during the thick of a historic pandemic and they will work in the better times ahead.” This year, more providers are considering the transition to accountable care which means taking on downside risk – something that is indeed risky without the appropriate tools and resources. We will see new opportunities with CHART, an extension of the popular Pathways to Success ACO program, and we will see providers tapping into 340B revenue – an opportunity that 80% of eligible providers have not yet pursued.
In this Spotlight, we are highlighting successful approaches and sharing testimonials from some Caravan ACO clients on the basics of successful accountable care. This is their ABCs of ACOs:
A = Annual Wellness Visit
By focusing on the AWV, providers have the opportunity to engage patients in their health care plan, identify gaps in care, and provide support and resources that will lead to improved outcomes and a better patient experience.
“Our focus needs to shift from sickness to wellness because how health care will be financed in the future will incent value, not volume. I asked the providers to do what they have always wanted to do: the right thing for the right reason at the right time.”
Steve Barnett, CEO
McKenzie Health System
B = Better Outcomes
Nurse-led initiatives leverages time for physicians and allows more time to be spent with patients on preventive care. Programs such as Advance Care Planning, Chronic Care Management, Behavioral Health Integration and more lead to improved patient outcomes.
When you look at how nursing has evolved, it's really a whole person approach and Advance Care Planning is a huge component. ACP is what's right for the patient. It's what's right for our care teams—being able to have the conversation prior to it becoming a critical situation.
Chastity Dolbec, RN
Coal Country Community Health Center
CCM is about better care and helping to reduce admissions. The program allows nurses to spend more time talking with patients, which is extremely important. We see this as a huge advantage in helping improve our patient care.
Verlin K. Janzen, M.D.
Medical Director, Medical Informatics & Population Health
Our behavioral health coordination program is absolutely outstanding. As a provider, it has enabled me to address my patient’s mental health in a more comprehensive manner. Every patient who has made contact with this program has had a greatly improved mental health outcome. This community is blessed to have this program.
JoAnna Reisert, FNP-C
C = Coding
Precise HCC coding enables staff and providers to not only identify gaps in care but also ensure that patient’s charts accurately reflect known conditions which leads to improved care coordination and optimized billing.
We’ve made it a priority to improve patient care. We feel like it’s not only an improvement for them and their care and their future wellbeing, but it’s also an improvement for us to show that we’re able to work comprehensively and try to address their health care needs.
Nellie Lunsford, Director of Compliance