Reducing Home Health Care Costs Through a Preferred Agency Network for an Accountable Care Organization

NEJM Catalyst ◽  
2021 ◽  
Vol 2 (7) ◽  
Author(s):  
Laura K. Minardi ◽  
Christine Rooney
Keyword(s):  
Health Care ◽  
Health Care Costs ◽  
Home Health Care ◽  
Accountable Care Organization ◽  
Home Health ◽  
Care Organization ◽  
Accountable Care ◽  
Care Costs

scholarly journals Hospitalization Rates Related to Coordinated Home Health Care Services With a Community Oncology Practice

2020 ◽  
Vol 16 (9) ◽  
pp. e1045-e1049
Author(s):  
John F. Sandbach ◽  
John Bachelor ◽  
Kimberly Larson ◽  
Denize Jordan ◽  
Janet Mullins ◽  
...  
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Home Health ◽  
Cost Of Care ◽  
Care Organization ◽  
Fee For Service ◽  
Hospitalization Rates ◽  
Community Oncology ◽  
Oncology Care

PURPOSE: Oncology care reimbursement has been shifting from a traditional fee-for-service model to either 1- or 2-sided risk models during the past 5 years. A major expense associated with the total cost of care is hospitalization cost. The study set out to investigate whether the creation of an Advanced Community Care Model (ACCM) of home health care would affect 60-day hospitalization and 30-rehospitalization rates in a community oncology setting. METHODS: In conjunction with a single home health care organization, an ACCM was modified for oncology care to include intervention protocols to address antiemetic issues, pain control, dehydration, shortness of breath, diarrhea, and fever. Weekly and monthly joint management meetings began. Quality metrics were defined. RESULTS: Overall, 457 unique home health care admissions were evaluated. Hospitalization associated with intervention protocols was evaluated. Sixty-day hospitalization rates decreased from 14% to 8%. Thirty-day rehospitalization rates decreased from 25% to 10%. CONCLUSION: An oncology ACCM, as created in this study, appears to have reduced both 60-day hospitalization and 30-day rehospitalization rates.

scholarly journals Morehouse Choice Accountable Care Organization and Education System (MCACO-ES): Integrated Model Delivering Equitable Quality Care

2019 ◽  
Vol 16 (17) ◽  
pp. 3084 ◽  
Author(s):  
Michelle Brown ◽  
Elizabeth O. Ofili ◽  
Debbie Okirie ◽  
Priscilla Pemu ◽  
Cheryl Franklin ◽  
...  
Keyword(s):  
Health Care ◽  
Education System ◽  
Care Delivery ◽  
Accountable Care Organization ◽  
Performance Outcomes ◽  
Care Organization ◽  
Business Practices ◽  
Accountable Care ◽  
Medicare Beneficiaries ◽  
Integration Model

Accountable Care Organizations (ACOs) seek sustainable innovation through the testing of new care delivery methods that promote shared goals among value-based health care collaborators. The Morehouse Choice Accountable Care Organization and Education System (MCACO-ES), or (M-ACO) is a physician led integrated delivery model participating in the Medicare Shared Savings Program (MSSP) offered through the Centers for Medicare and Medicaid Services (CMS) Innovation Center. The MSSP establishes incentivized, performance-based payment models for qualifying health care organizations serving traditional Medicare beneficiaries that promote collaborative efficiency models designed to mitigate fragmented and insufficient access to health care, reduce unnecessary cost, and improve clinical outcomes. The M-ACO integration model is administered through participant organizations that include a multi-site community based academic practice, independent physician practices, and federally qualified health center systems (FQHCs). This manuscript aims to present a descriptive and exploratory assessment of health care programs and related innovation methods that validate M-ACO as a reliable simulator to implement, evaluate, and refine M-ACO’s integration model to render value-based performance outcomes over time. A part of the research approach also includes early outcomes and lessons learned advancing the framework for ongoing testing of M-ACO’s integration model across independently owned, rural, and urban health care locations that predominantly serve low-income, traditional Medicare beneficiaries, (including those who also qualify for Medicaid benefits (also referred to as “dual eligibles”). M-ACO seeks to determine how integration potentially impacts targeted performance results. As a simulator to test value-based innovation and related clinical and business practices, M-ACO uses enterprise-level data and advanced analytics to measure certain areas, including: 1) health program insight and effectiveness; 2) optimal implementation process and workflows that align primary care with specialists to expand access to care; 3) chronic care management/coordination deployment as an effective extender service to physicians and patients risk stratified based on defined clinical and social determinant criteria; 4) adoption of technology tools for patient outreach and engagement, including a mobile application for remote biometric monitoring and telemedicine; and 5) use of structured communication platforms that enable practitioner engagement and ongoing training regarding the shift from volume to value-based care delivery.

Mental Health Care in the Accountable Care Organization

2013 ◽  
Vol 64 (9) ◽  
pp. 908-910 ◽  
Author(s):  
Donovan T. Maust ◽  
David W. Oslin ◽  
Steven C. Marcus
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Accountable Care Organization ◽  
Care Organization ◽  
Accountable Care

Health Care Utilization Following Vagus Nerve Stimulation Therapy in Pediatric Epilepsy Patients From a Pediatric Accountable Care Organization

2017 ◽  
Vol 33 (2) ◽  
pp. 136-139
Author(s):  
Anup Patel ◽  
Ling Wang ◽  
Satyanarayana Gedela
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Accountable Care Organization ◽  
Care Utilization ◽  
Pediatric Epilepsy ◽  
Care Organization ◽  
Accountable Care

Background: Vagus nerve stimulation has been a therapy for epilepsy approved by the US Food and Drug Administration (FDA) for patients 4 and older and shown efficacy and safety in younger pediatric patients. Methods: The authors performed a retrospective analysis utilizing Medicaid claims from an accountable care organization to measure the intervention of vagus nerve stimulation therapy in regard to unplanned health care utilization. Thirteen unique patients were included who had vagus nerve stimulation therapy who had at least 6 months of continuous enrollment in a managed Medicaid health plan. Comparison with 12 months of data before and after vagus nerve stimulation implantation was performed. Results: Patients had statistically significant fewer unplanned inpatient visits per patient per enrollment month after vagus nerve stimulation implantation. Conclusion: Utilizing claims data, vagus nerve stimulation implantation demonstrates a reduction in unplanned hospitalizations.

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