Pioneer ACO to Specialists:
If the Care Coordination Role Fits, Wear It

As far as Medicare beneficiaries are concerned, it's time for healthcare to acknowledge specialists as principal caregivers of the chronically ill, advises Monarch HealthCare, a top-performing CMS Pioneer ACO.

Monarch came to this realization in year one of participation in CMS's Pioneer ACO program, when it discovered that 70 to 80 percent of office visits by its 14,000 accountable care organization (ACO) patients were to specialists.

Colin LeClair

"We have to start treating [specialists] like a primary care provider (PCP), especially for those patients that are chronically ill, where it is actually appropriate that a cardiologist is the primary care giver for a patient with CHF and coronary artery disease (CAD)," said Colin LeClair, Monarch HealthCare's executive director of ACO.

Engaging and incentivizing specialists in its ACO are two key facets of Monarch's year three performance strategy, noted LeClair during a recent webinar, Medicare Pioneer ACO Year One: Lessons from a Top-Performer. Going forward, Monarch plans to tap patient data from specialist encounters to enhance its care management and quality improvement efforts.

In case you missed this webinar, you still have a chance to watch this highly-rated program.

Register to view the conference today or order your training DVD or CD:
http://store.hin.com/product.asp?itemid=4695

Despite its regret at not engaging specialists earlier, Monarch's Pioneer ACO has plenty to be pleased about at the outset of year two, in which the number of ACO-attributed patients has swelled to 22,000 patients.

In terms of quality performance, Monarch, the largest IPA in Orange County, Calif., was year one's top scorer in several patient-centered metrics in the Pioneer ACO program, and the second highest performer in the area of medical cost reduction a result largely driven by reductions in hospital and skilled nursing facility (SNF) utilization and unit costs, noted LeClair.

Monarch is one of 32 originally selected CMS Pioneer ACOs. Today, 23 remain in the program.

During the 45-minute program, LeClair outlined Monarch's six-step ACO implementation strategy, a patient-centered approach built around risk stratification, ACO team-building, and care management. Trial and error during the first year yielded some interesting findings, such as the optimal time to engage a patient, he said.

You can "attend" this program right in your office and learn why Monarch chose to participate in the Pioneer Program, performance year one Implementation, performance year one results, key success drivers, lessons learned, performance year three strategy and the future of the ACO model.

Its so convenient! Invite your staff members to watch the conference. We will send you a DVD or CD-ROM of the conference proceedings or a link to our web site with a username and password. You can log in and view the program right from your computer any time of the day or night, whenever convenient for you and your colleagues and benefit from the archived recording of the conference, including the Q&A period.

You'll get to listen to the question and answer session to hear the most effective intervention effort post-discharge to reduce hospital readmissions for CHF and COPD patients, how to coordinate care for patients who visit non-network physicians, strategies to increase the number of patients who complete health assessments, populations and/or conditions that merit a home visit by physicians, how Monarch's participation in the Medicare Pioneer ACO program is impacting its participation in other ACOs, physician endorsement of the ACO to patients and an analysis of Monarch's shared savings in 2013 in offsettting ACO administrative costs.

To register for the on-demand re-broadcast, download an .MP3 file or order the training DVD or CD-ROM of Medicare Pioneer ACO Year One: Lessons from a Top-Performer, please visit:
http://store.hin.com/product.asp?itemid=4695

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 accountable care resources: