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Accretive Health - Quality Total Cost of Care - Health Care QualityDocument Transcript
QUALITY AND TOTAL COST OF CARE“Today our healthcare system is burdened by enormous expense without great return. We are now atthe point that our country’s prosperity is financially at risk if we don’t change the way we deliverhealthcare. With our Quality and Total Cost of Care offering, we have developed a model ofinnovative care that focuses on continuously improving value. We work side by side with ourhealthcare partners to empower patients and physicians. Our mission is to provide our healthcarepartners with people, processes and technology that will allow them to deliver the best quality care atsustainably lower costs.” Dr. Walter Ettinger, Senior Vice President Accretive Health, Professor ofMedicine, University of Massachusetts Medical School and Retired President UMass-MemorialMedical Center.Accretive Health’s Quality and Total Cost of Care is a continuous care assessment and patient populationmanagement solution that helps physicians provide patient-focused, integrated care. We know that, inorder to solve the fundamental problems of quality and cost in our healthcare system, we must offersolutions that improve value across the care continuum by matching care with the needs of the patient,proactively and efficiently.Our mission is to partner with healthcare providers to help them become accountable careorganizations that can improve the health of a population and reduce the costs of care . Our solutionassists healthcare providers in creating improved quality of care, enhanced accessibility to care for thosemost vulnerable and greater efficiencies to make quality care more affordable and sustainable.Better quality is the challenge. Today, U.S. healthcare costs are the highest in the world, yet consistentquality can be comparatively low. Too often care is fragmented and focuses on treating episodes ofacute illness. Patients with chronic illness get lost in a maze of providers without coordination of theircare. The outcome of this approach results in overuse and dupli cation of services and a focus on curingthe illness rather than prevention.Quality and Total Cost of Care is the solution. Through our Quality and Total Cost of Care solution,Accretive Health is working to transition healthcare to a value-based system of total quality care. We areforming partnerships with providers to establish accountable care organizations that achieve the aim ofbetter experiences for patients at lower overall costs.Solutions for patients: Creates a patient-centric relationship through an integrated approach aimed athelping healthcare providers keep patients healthy and coordinating their care both inside and outsidethe walls of the clinic, hospital or other place of care.Solutions for physicians: Enables physicians to focus on the most vulnerable patients by identifyingthose who are most at risk for worsening health, providing coordinated care, and preventing illness witha commitment to delivering the right care at the right place in a timely manner.Solutions for hospitals and healthcare systems: Helps drive greater efficiency by focusing on the areasof need that account for 60 percent of the patient population’s healthcare costs.
Our solution is built on an integrated set of principles: Improving quality of patient care/outcomes, while reducing unnecessary costs Helping healthcare providers engage patients in wellness and shared decision making Physician-led care, with appropriate incentives to promote health and wellness Data-driven, fact-based solutions, not presumptionsLearn more about our transformative Quality and Total Cost of Care solution:Core SolutionPeopleProcessesTechnologyMeasurable ResultsCase StudyCore SolutionAccretive Health is committed to correcting the imbalance between quality and cost by partnering withproviders, physicians, hospitals and payers to create an improved care experience for those patientsmost at risk. We equip physicians with the information and analytical tools necessary to make the rightclinical decisions in the appropriate settings and at the appropriate time for their patients. By educatingpatients and administering care early in the disease process, providers can decrease costs and improveoutcomes over the life of a patient.We apply our operational and clinical expertise to execute a patient-centered physician engagementstrategy that emphasizes a collaborative team- based approach fulfilled through our people, processesand proprietary technology. Our value-based model promotes highly focused and intense treatmentoptions that physicians can apply to those patients most vulnerable. We keep physicians informed withmeaningful analytics, facilitating much greater insight into the context of how a patient’s diseaseimpacts all areas of health. Our data also allows the provider to focus greater efforts on managing thesepatients within and across the delivery system, as well as at home.Primary care physicians are supported with care managers, social workers, pharmacists and other teammembers to allow them to extend their influence outside of the examining room. This integrated careapproach creates a patient-centric relationship that delivers value by keeping the patient healthy andproviding the right care at the right place in a timely fashion. By providing the information and toolsnecessary to make the best clinical decisions, our model ensures that primary care physicians enjoy a
more meaningful experience practicing medicine while realizing the economic benefit of more efficientcare delivery.PeopleThrough Quality and Total Cost of Care, patient care is delivered in a team-based approach. Clinical carecoordinators and outreach coordinators are embedded within the primary care physician’s practice, andthis core team works with your clinical staff to implement the initiatives that drive clinical and economicvalue. Social workers and clinical pharmacists are included on the team, as needed. In addition, expertsin day-to-day clinical operations work with physicians and their staff to maximize effectiveness andefficiency of the team.Our goal is to help physicians and hospital networks deliver total care of a population at the right leveland the right time. We are there with you every step of the way to help you provide high qualit y care,patient satisfaction and cost reduction.ProcessesWith Quality and Total Cost of Care, we help healthcare providers focus on those patients most likely toneed future medical care and increase access for those patients to the right physicians as early as theneed is determined.Total system value propositionOur solution is a total system value proposition financed by the savings achieved through our model.We provide the capital, resources and infrastructure necessary to make the transition to accountablecare. As your operating partner, we share with you, your physicians, and participating payers in theverified cost savings associated with delivering higher value care.Patient prioritizationProprietary algorithms help predict the small percentage of patients, within a population panel, whohave chronic diseases and conditions, and who require integrated, proactive care to increase both theeffectiveness and efficiency of their treatments. This knowledge helps your physicians dedicate the rightamount of focus on the patients who will require the majority of care and drive the majority ofunnecessary costs.Optimal care plansPrimary care physicians, in collaboration with other team members, use our extensive database andknowledge of available medical resources to create individualized care plans for all patients. Throughcomprehensive delivery and access planning, care coordination and admission management, we partner
with physicians to optimize capacity for priority population care, and our teams monitor and supportadherence to the optimal care plans developed by the physician and patient.Patient engagement supportWe provide physicians with the line of sight, education and support required to improve outcomes forpatients most in need, while transforming their revenue, cost and service visibility across the entire carecontinuum. Coaching and education programs include performance management, population-basedopportunity reviews, delivery training, and benefit/eligibility training and provider service issues.Analytics and reportingAnalytics and reporting mechanisms are embedded throughout our platform to ensure that allprocesses are driving value. This includes a wide array of benchmarking data that helps determine bestquality outcomes across a myriad of evaluation points.TechnologyQuality and Total Cost of Care offers a world- class technology platform that enables providers to takeaccountability for population health. Our proprietary applications provide the visibility and day -to-daytools your primary care physicians need to provide the right level of care at the right time.Our proprietary AccretiveQ software suite consists of two broad domains: “Analytics” and “Workflow.”They provide visibility into, and better control of, the full spectrum of services, quality of care andassociated costs for all patients. With these tools, care management staff can focus extra effort on highpriority patients while still being able to monitor all patients effectively.AnalyticsThe analytics domain provides physicians with on-line analytical processing capabilities so that they canmore easily and accurately monitor patient results by grouping patients with similar healthcareattributes, demographics and other factors. The analytics domain is also used to monitor the progress ofindividual physicians, physician practices or clinics toward adopting processes designed to enhanceclinical outcomes with lower total cost of care for the defined patient populations.WorkflowOur workflow domain uses a combination of proprietary algorithms and industry standard applicationsto identify patients who are most likely to have an adverse health event. The domain then automaticallyassigns the patient to an appropriate care coordinator, assists in developing the patient’s care plan, andserves as a tool for scheduling the appropriate care interventions. The workflow solution also monitorsvariation in care plan activities and the success rate of applying the care plan’s parameters.
Measurable ResultsThrough our holistic approach consisting of people, processes and technology, you can improve thepatient’s experience and improve the health of a defined patient population while ultimately reducingthe total cost of care. We work together with the health system, physicians and third-party payers toreduce healthcare costs, while improving quality of care. When measurable economic benefits arerealized through our Quality and Total Cost of Care solution, the provider, its physicians, participatingpayers and Accretive Health share equitably in the cost savings created.Quality Total Cost of Care delivers measurable results that include: Improvements in patient satisfaction and engagement Improvements in measures of population health Reduction in unnecessary emergency room use Reduction in inpatient admissions and readmissions Improvements in primary care physician satisfaction