Monday, November 05, 2018
by Karen Gallagher • email@example.com
BJC | Improved patient outcomes, provided at a more efficient cost for Medicare patients, has resulted in BJC Accountable Care Organization (ACO) achieving shared savings. The savings will be distributed among ACO participants.
The Medicare Shared Savings Program rewards ACOs that lower health care costs while delivering high-quality care. In 2017, ACOs were measured on 32 Centers for Medicare and Medicaid Services quality measures relating to care coordination and patient safety, appropriate use of preventive health services, improved care for at-risk populations, and patient and caregiver experience of care.
The BJC ACO overall quality score for 2017 was 97.99 percent, an improvement from 2016’s score of 92.63 percent, demonstrating significant improvement in 12 quality indicators compared to the previous year. The average score for ACOs across the country was 90 percent.
According to Nancy Kadlec, BJC Medical Group vice president and chief nursing officer, costs were reduced through increased tracking and reporting, primary care physician (PCP) education and care management efforts.
“A tremendous amount of work was done to aggregate data and produce reports for the PCPs, skilled nursing facilities and home health, reflecting their performance for the previous quarter,” she says. “We also began meeting with providers twice a year to review the reports, discuss ACO initiatives and get their feedback. This forum of sharing information and providing education around the ACO’s initiatives and defining the provider’s role, helped underline the importance of this program.”
Megan Guinn, program director, says the ACO’s care management team worked by phone with patients transitioning home from the hospital or with chronic conditions, helping them understand discharge instructions and their medications, providing education on their condition and scheduling follow-up visits with doctors.
“Patients benefit from working with a care manager,” Guinn says. “Care managers help patients stay independent and out of hospitals by providing them with education about their condition and connecting patients and family members to helpful resources. Our work toward preventive care and wellness measures resulted in quality reward points for significant improvement.”
Improving the quality of patient care while lowering health care costs was only possible through better collaboration among patients, physicians and hospitals, says Doug Pogue, MD, BJC Medical Group president.
“The BJC ACO provides a full continuum of services through an integrated network of health care delivery settings in Missouri and Illinois,” Dr. Pogue says. “BJC’s network of physicians take care of seniors in a very positive way. BJC ACO collaborates with physicians for well-communicated care of patients, making patients healthier and allowing us to follow patients through different care platforms in a more coordinated, transparent way.”
BJC ACO is the only integrated health system in the area to earn shared savings in 2017.
“We have also advanced our technology infrastructure to better meet the needs of our clinical care teams,” says Karen Shakiba, operations program director. “We have also focused on increasing awareness of our mission throughout the organization and provider communities, and created more transparency through reporting and analytics.”
BJC ACO was also recently recognized by the American Cancer Society for exceeding its national goal of screening more than 80 percent of eligible seniors for colorectal cancer.
Doctors, hospitals and health care providers establish ACOs in order to work together to provide higher-quality coordinated care to their patients, while helping to slow health care cost growth. Beneficiaries seeing health care providers in ACOs always have the freedom to choose doctors inside or outside the ACO.
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