Advanced Care Coordination: Bridging the Gap Between Appropriate Levels of Care and Care Plan Adherence for ACO Attributed Lives

Advanced Care Coordination: Bridging
the Gap Between Appropriate Levels of Care
and Care Plan Adherence for ACO Attributed Lives

There's still time to register for tomorrow's webinar, Advanced Care Coordination: Bridging the Gap Between Appropriate Levels of Care and Care Plan Adherence for ACO Attributed Lives.

As UT Southwestern Accountable Care Network (UTSACN) enters the last quarter of its three-year Medicare Shared Savings Program and reflects on its growth in attributed lives and provider participation, along with its success in achieving shared savings in both 2014 and 2015, it credits its continued success in managing utilization to its advanced care coordination program.

UTSACN, which has applied for both of CMS' upcoming value-based programs, Next Generation ACO and MSSP Track 3, has seen its attributed lives grow from 19,000 in 2014 to 250,000 this year and substantial growth in the number of participating PCPs, and has entered into three risk-based contracts with commercial plans as it moves toward more at risk-models.

Advanced Care Coordination: Bridging the Gap Between Appropriate Levels of Care and Care Plan Adherence for ACO Attributed LivesDuring the webinar, which starts at 1:30 p.m. Eastern, Cathy Bryan, director, care coordination at UT Southwestern, will share how her organization's care coordination model manages utilization while achieving its mission of bridging the gap from where patients are to where they need to be to adhere to their care plan. Ms. Bryan will also share the key details behind its Home Health Evaluation Program, which saved the health system $6 million in just its first quarter.

Register for the webinar today or order your training DVD or CD:
http://store.hin.com/product.asp?itemid=5175

You will learn how UTSACN's care coordination model:

  • Uses a combined strategy to identify patients in need of care coordination, including a predictive model, PCP referral, hospital and ED utilization data and leveraging its own data warehouse;
  • Takes a whole-patient approach to care coordination, addressing the socio-economic, education and pysch/social issues that can impact patients through a team-based approach of nurse care coordinators and community health workers;
  • Develops relationships with PCPs and becomes an extension of the provider at the patient level through its care coordinators embedded in the primary care practice, as well as telephonic and home visits; and
  • Delved into its data warehouse and identified home health as a key area in need of care coordination…and saved the health system $6 million in just one quarter by managing home health over-utilization while providing patients with the services they needed at the most appropriate level of care.

You can "attend" this program right in your office. It's so convenient! Invite your staff members to participate in the conference. We will send you a login to access the webinar or a DVD or CD-ROM of the conference proceedings once it's available for shipping.

You'll also have the opportunity to have all of your questions answered by Cathy Bryan during the interactive question and answer session. You'll get answers to your care coordination questions and challenges.

To register for the conference, the on-demand re-broadcast or MP3 download file or order the training DVD or CD-ROM of Advanced Care Coordination: Bridging the Gap Between Appropriate Levels of Care and Care Plan Adherence for ACO Attributed Lives, please visit:
http://store.hin.com/product.asp?itemid=5175

I hope you find it useful.

Cordially,

Melanie Matthews
Executive Vice President
The Healthcare Intelligence Network

P.S. -- You may also be interested in these care coordination resources: