Earlier this year, Caravan Health welcomed a new Chief Medical Officer, Dr. Ashok Roy. Dr. Roy is trained as an internal medicine physician and brings a wealth of experience in population health and value-based payment to our team. 

Working closely with our ACO medical directors and clinical staff, Dr. Roy will bring us up to date on this work at our 2020 Virtual Accountable Care Symposium. Today's blog previews what we can expect during the Better Patient Care track.

What are the most important takeaways on the value of team-based care?

Team-based care is the foundation to successful value-based payment. In an ACO, our team-based approach leads to outstanding care quality and more satisfied patients and providers. We also see a direct tie to reaching financial targets. Working together as a coordinated team reduces inpatient admissions and unnecessary procedures. The best part is that team-based care does not require extra resources or costs, but just requires a plan for coordination.

In the COVID-19 public health emergency, we have seen again and again that team-based population health care delivery is the key to being ready for the unexpected. ACO participants have tremendous baseline knowledge about the health of their patient populations. That makes them ready to stay in touch with the patients who are at risk of hospitalization or worsening chronic conditions. Population health services like the annual wellness visit give invaluable information about where to dedicate resources. Established chronic care management programs mean that we are already in touch with patients who are dealing with multiple chronic conditions. Care managers can provide personalized service, because they have been doing it all along.

What are the best practices for team-based care as we manage through the COVID-19 pandemic?  

The past year has driven home the value of delivering care in alternative ways. Many low-acuity conditions are appropriately addressed over the phone, rather than in the clinic. Keeping patients at home who don’t need to be in the clinic benefits everyone. Virtual care services can often be provided more quickly, so if a condition is more serious than it originally appeared, the provider can escalate the situation appropriately.
Practices also have to be especially aware of avoiding clinician burnout. Everyone on the team should have set roles working at the top of their license. We sometimes see nurses managing workflows, but that may not be the best use of their time and skills. Figuring out how to make the most of each member of the team is critical.
Over the past few months, with the pandemic and the resulting economic fallout, all health practices have to go beyond their normal delivery of medical care and understand more about patient situations. Has someone in the home lost a job? Does the patient and their family have enough food in the home? Do they have the transportation they need to get medical care? Population health work and a personalized approach to care puts ACO participants far ahead as we tackle these unprecedented times.

What is the role of technology in team-based care?

Technology can make the whole system work. A patient can wear a device monitoring vital signs, which gives providers information about where they should spend their time. A monitoring device can also stretch the time and attention of a single care manager. Getting the care team smarter about how to dedicate resources creates an environment of lower burnout and higher morale. Working together, the team can figure out who is at high risk of hospitalization of worsening of chronic illness.

Hear more from Dr. Roy, including how team-based care can help an ACO get ready for downside risk at the Accountable Care Symposium. Learn more and register here.

Recent Resources

CMS Actions in Response to the COVID-19 Public Health Emergency

The Centers for Medicare and Medicaid Services just issued a lengthy set of policy changes to address the growing COVID-19 public health emergency (PHE). These changes will help hospitals and health providers to respond to the crisis more quickly and safely, including many more options for telehealth in Medicare.

ACO, Policy, Webinars & Events, Quality, Value-Based Care, COVID-19

Stop Standing Still: How to Get Started in a High-Performing Caravan Health ACO

Tuesday, September 24 at 9:00am PT / 12:00pm ET

ACO, Webinars & Events

10 Reasons ACOs Can Fail

Just published in Becker’s Hospital Review – Caravan Health Senior Vice President Tim Gronniger discusses ten reasons Accountable Care Organizations can fail.

ACO, Blogs & News, Value-Based Care


Stay up to date on the latest info on value-based care - visit our resources page

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