5 Ideas to Improve ACO Performance Results

5 Ideas to Improve ACO Performance Results

Beyond the EMR: Mining Population Health Analytics to Elevate Accountable CareOne step John C. Lincoln network took to improve performance results at the end of its first year as a Medicare Shared Savings Program accountable care organization (MSSP ACO) was to focus on a relatively small number of patients, the top 5 percent of beneficiaries by claims volume who actually account for about 60 percent of medical spend, explains Heather Jelonek, CEO for ACOs at John C. Lincoln Network, who shares additional strategies here.

First, we decided to institute wellness visits across our health system. We’ve worked with several large third party payors here in the valley where they’re now recognizing the Medicare G-codes for wellness visits. We bring those patients in and get a full survey of what’s been going on with them.

Second, we’re engaging in regular population management. We now have our physicians talking about how often they want to see their patients with diabetes or hypertension or cancer.

Third, we're also starting to focus on those individuals who are ‘aging in;’ those patients who are about 62½. We’re trying to get them in and get them into a routine, making sure they’ve got A1C scores every quarter and every six months, and have had their flu shots and colonoscopies. We’re hoping a healthier generation of individuals coming into the Medicare program improves the quality outcomes that we’ll see long-term.

Fourth, we've developed a standardization for our quality reporting. We’ve looked at the top 5 percent of our beneficiaries by claims volume, who actually account for about 60 percent of our medical spend. We’re hoping that by focusing on a relatively small number of patients, we’ll have a drastic impact on outcomes.

Next, we're also leveraging our electronic medical record (EMR) to the fullest extent; we’re participating in a number of conversations and baseline studies with EPIC®. They are very interested in seeing what we’ve done with the tool and how we’re making it usable for our ACO reporting.

Ms. Jelonek, along with Karen Furbush, business consultant with John C. Lincoln Network, describe the sources combed by the ACO to address operational and technological challenges during the pre-launch period, and how these efforts and resulting data enhanced quality measurement and reporting for the JCL ACO in the new guide, Beyond the EMR: Mining Population Health Analytics to Elevate Accountable Care. For more information or to order your copy today:

This HIN special report provides details on the following:

  • Workarounds for data gathering that help to reconcile disparate EMR systems;
  • Creation of a care transition team that tapped a valuable and underutilized worforce segment and the team's impact on readmissions rates;
  • Immediate changes made to workflow processes;
  • Enhancements made to the patient health questionnaire;
  • The challenges of scouring CMS claims data to highlight gaps in care;
  • Enlisting physician practices to help fill in care gaps and provide feedback via a new Physician Network;
  • Leveraging monthly ACO reporting calls;
  • Updating its Medicare Wellness Template to identify care needs for its aging population;
  • Analyzing integration opportunities;

and much more.

For more information or to order your copy today, click here now:

Available in Single or Multi-User Licenses

A multi-user license will provide you with the right to install and use this information on your company's computer network for an unlimited number of additional workstations within your organization for a one-time fee. To have this valuable resource on your network, or to inquire about ordering bulk copies in print or Adobe PDF, please e-mail sales@hin.com or call 888-446-3530.

P.S. -- You may also be interested in these population health management resources: