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You’ve been trying to make these numbers work for years. And now, with the increasing pressure to transition to value-based care, it’s going to be even harder to keep your head above water. You know that sooner or later you’re going to have to make the transition. But you have no idea how you’re going to pay for it.
With Caravan Health, now the numbers work. With a proven model for turning population health from a cost center into a revenue center, health care providers can make their value-based care initiative pay for itself. Hospitals are often concerned about the financial changes that could come with ACO participation. Our experience shows that that the ACO model is an ideal business model for hospitals willing to invest their networks, delivering near-term returns even apart from shared savings. Driven by increased wellness utilization and market share, Caravan Health partners thrive.
We are the nation’s leader in accountable health care for a reason: we know how to generate new, sustainable revenue using value-based care models. It starts with scale. Our models have proven that there’s strength in numbers and we not only have the numbers in our Collaborative ACO – the nation’s largest – but we also know how to create success.
We start by benchmarking our ACO results and compare to other provider partners as well as the rest of the country. Our governance, accountability, and transparency model produces results that consistently lead to high quality scores and savings for Medicare.
One practice that has become essential to generating sustainable revenue in the COVID-19 era are virtual care services. As the global pandemic continues to disrupt our nation’s health care delivery system, the opportunity to open virtual doors to patients has become available to providers everywhere. Providers have been tasked with reengineering their delivery methods and are beginning to reach beyond their physical structures to see patients virtually through telehealth visits.
Telehealth visits have increased 30% and even higher in certain areas. By deploying new care delivery and Chronic Care Management (CCM) strategies, providers are not as vulnerable to the decrease in patient visits and decline in revenue. Annual Wellness Visits (AWVs), once only be conducted in person, have been successfully transitioned to telehealth with nurse-led exams which has helped to insure against financial instability. These virtual visits have also provided the opportunities for providers to enroll patients into CCM programs. With the ability to conduct AWVs and CCM with telehealth, providers are able to sustain their level of care delivery, optimize revenue opportunities, while also focusing on their high-risk patients.
Virtual care is likely to remain intact for the foreseeable future and this new form of care delivery combined with value-based care models that have proven to be successful will help providers increase outpatient revenues and ensure patients stay in network which effectively improves the continuity of their care experience and enriches your bottom line.
The Merit-based Incentive Payment System (MIPS) is one of two tracks in the Quality Payment Program. On average, high-performing practices that belong to an ACO report much higher MIPS scores than their peers. ACO providers have MIPS quality scores that rate higher due to utilizing specific claims data that helps identify gaps and uncover missing results, the treatment of cost data, and a full six weeks to polish data prior to submission.
ACOs are only required to report on a sample of their attributed patients. By optimizing Caravan’s proprietary population health analytics, our providers consistently report an average MIPS score of more than 95% - well above the the national average.
The effects of MACRA on Community Hospitals
To take advantage of special MIPS scoring rules, hospitals and their affiliated clinical networks can avoid hundreds of thousands of dollars in penalties – and earn bonuses – by enrolling in a risk-based ACO. But most ACOs risk losing income because they are too small to outperform statistical variation. This is where scale comes in.
It all sounds great on paper – 5,000 lives and you’re in. But too many hospital systems and providers have tried and failed. A successful launch year turns into the next year’s declining numbers – even when you are doing everything right. Caravan Health knows how to make the numbers work. We show our partners how to successfully take on risk and generate new revenue. With Caravan Health, risk doesn’t have to be risky.
For example, ACO participants who take on risk will receive 5% lump sum payments that are not accounted for in shared savings and will be exempt from MIPS reporting. We work with our partners to reduce performance uncertainty by 85% and ensure results are within 1% of true performance. We are so confident in our proven population health model that we cover any losses greater than 1% in exchange for an additional 10% of shared savings.
By successfully taking on risk, hospital systems position themselves to be more competitive with other providers and in recruitment efforts. Providers must take on risk to attract the best physicians because in 2026, every year a clinician does not take risk their lifetime earning potential decreases by 0.5%.
We have found the key to reliably getting shared savings: banding together with other organizations into a Collaborative ACO with at least 100,000 lives. Our expertise in this proven model reveals opportunities for small and mid-sized hospitals to achieve the benefits of scale while maintaining independence by working in Collaborative ACOs that mitigate risk.
Deadline to join a Caravan-supported ACO is August 3. Speak with a Caravan expert today.
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