You have heard all about the move to value-based payment but joining an ACO can feel like a financial leap of faith. Transforming your method of care delivery requires investing in new processes, systems, and staffing. How can you be sure that these investments will pay off?
Sometimes new ACO members are concerned that they don’t have the right staffing in place to fully implement a new population health management program. The truth is that most practices can get started with just a few population health nurses who can deliver revenue-generating services right away. The best part? These services get patients on the right track, creating long-term financial stability by improving health outcomes and leading to lower overall costs and shared savings.
In a Caravan Health collaborative ACO, we estimate that the total investment, including population health nurse staff and our proven Caravan Health tools, training, and expertise, will cost about $50 – 75 per attributed Medicare beneficiary per year. That can be a significant investment for a small health practice.
But take a look at the other side of the ledger. A typical ACO provider will earn $375 on that same attributed Medicare beneficiary each year. These are real dollars that would be simply lost without the ACO model. Here is how it breaks down:
- $75 in population health revenue, a direct return on investment in staffing
- $100 in 340B optimization, our system can get you more of the prescription drug discounts available through this important program
- $150 in shared savings, going directly back to the provider doing the work
- $50 in MIPS and/or Advanced APM bonuses, these incentives keep high quality at the center of patient care
This isn’t just a theory – we have seen population health economics at work at our more than 250 health practices across the country.
Crouse Health in Syracuse, New York has staffing and systems solidly in place and continued to perform annual wellness visits throughout the COVID-19 pandemic, sometimes at even higher rates. They had also prioritized another population health initiative, advance care planning, as part of their annual wellness exams. They exceeded their pre-pandemic goal for ACP by more than 10% from the beginning of 2020 through the third quarter. Crouse achieved similar results with their chronic care management program, which flourished as a result of their emphasis on virtual care. The program grew by more than 2% during the pandemic.
Crawford County Memorial Hospital in Denison, Iowa has been in a Caravan Health Collaborative ACO for three years. Their diabetes management program got a boost from joining the ACO. Through a combination of interventions, including chronic care management, and tracking the Hemoglobin A1c poor control measure, and continuous glucose monitoring, Crawford patients saw significant improvements in blood sugar measurements.
Get in touch with Caravan Health today to learn more about the economics of a Caravan Health ACO.