Managing Value

in the new care delivery models

In the current care models, the patient’s episode of care can start anywhere because the system is still hospital and healthcare system-centric.  We must flip that model to be “patient-centric.”

If a patient calls the doctor’s office, most likely, what they hear on the phone is, “We can see you in two weeks.”

Most patient’s symptoms can’t wait for two weeks!

In fact, the same doctor’s office recommends to go to the “Emergency Room” if they feel it’s a medical emergency.  What the office staff fails to recognize is that, when you don’t feel well- it feels like an emergency!

At times, patients are advised to go to “Urgent Care,” where a patient has to wait to see a provider and often, you can’t access urgent care unless is after hours.

This vicious cycle does not leave many alternatives for patients, often allowing the episode of care to begin in the most expensive care setting and the most inconvenient setting for the patient.

With the convergence of technology and knowledge, this can be avoided.

More importantly, if the patient requires post-acute care, they are left to fend for themselves in new settings, with new care teams and often confused.  This is because most post-acute care facilities function in silos with their own regulations, separate reimbursement and different incentives for care delivery aligned with FFS- to provide more (volume) versus better care (value).

If your organization is an ACO or a risk-based contract provider under MSSP, you cannot afford to lose money in this way.

There is a better way with a new model, learn how.

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ED Visits Unnecessary

Percent

An analysis of insurance claims data for more than 6.5million ED visits in 2010 conducted by Truven Health Analytics, found that 71% of ED visits are unnecessary or could have been avoided.

Current Model

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Ambulatory Care Sensitive Conditions

Million

A research study conducted in 2012 that analyzed data for 78,114 ED visits by adults aged 18 and older, found that 8.4% of those were for ACSC, which represent 8 million potentially avoidable ED visits. (ISSN: 0025-7079)

We partner with you to establish the new generation model of care delivery, which can change everything.

Why wait to capture the episode of care at the hospital, urgent care center or other expensive settings when it’s too late to avoid unnecessary cost.

We use technology and professional care coordination services to align with your inter-disciplinary teams to deliver a better patient experience, reduce unnecessary costs and improve care outcomes.

Capture the Episode of Care when it matters to provide care at the right time, at the right place, by the right provider necessary.

New Model

Scalable and Measurable Solutions

Our bundled services directly integrates with your organization to impact three specific things:

Patient Satisfaction: It is proven in all industries that consumers want less hassles, less cost and higher quality.  We assist you in delivering these important components of service to engage your patient populations.

Capture The Savings: It is certain that under the Medicare Shared Savings Program (MSSP) or the commercial programs, there is a quality improvement agreement that must be met in order for the ACO to receive a percentage of the realized savings. Without improving or maintaining quality, decreased costs will not result in financial gain.  We assist you in capturing the savings through managing patient care with you through all care settings, proactive interventions and increased patient adherence to therapeutic treatments.  More importantly, capturing the episode of care at the right time, in the right place, by the right provider level.

Improved Outcomes: ACOs that maintain high quality performance are increasingly rewarded with better performance.  We assist you to increase performance and deliver higher quality by personalized care programs that increase patient satisfaction and patient retention.

Value-based Healthcare Revolution

Better care. Less hassle.

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Percent

By 2018, 90% of Hospital payments will be linked through programs such as the Hospital Readmissions Reduction Programs.

HHS has set specific goals to link traditional, or fee-for-service, Medicare payments to quality or value through alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment arrangements by the end of 2016, and tying 50 percent of payments to these models by the end of 2018.

The department of Health and Human Services (HHS) accelerates the revolution in new payment models and value-based payments.

Transforming Healthcare through
Coordinated Care Solutions

View the first step of the New Model: Predictive Analytics

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