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Dartmouth discusses its ACO woes

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Dartmouth-Hitchcock Medical Center.

Healthcare leaders at the Geisel School of Medicine at Dartmouth College and the affiliated Dartmouth-Hitchcock Medical Center have been busily explaining to the national news media their decision to scrap their Accountable Care Organization — a  model mostly invented at Dartmouth.

A New York Times story said that Dartmouth’s ACO cut Medicare costs on hospital stays, tests, imaging and other procedures. But although it met its goal for quality of care, the Feds still penalized Dartmouth’s ACO  for not reaching cost-savings benchmarks, which prompted it to exit the program last fall.

Robert A. Greene, M.D., an executive vice president in the Dartmouth-Hitchcock Health System, told  The New York Times that  that the cost-cutting, in combination with federal penalties, was not sustainable for the system. Elliot S. Fisher, M.D., director of Dartmouth Institute for Health Policy and Clinical Practice and one of the designers of the ACO model, noted the disappointment of himself and his colleagues.

“It’s hard to achieve savings if, like Dartmouth, you are a low-cost provider to begin with,” Dr. Fisher told The Times.

A Health Affairs blog post said that  the Centers for Medicare & Medicaid Services  data suggest that while more ACOs are finding success,  financial performance and health outcomes can vary widely across America. In late August, CMS reported that that fewer than a third of ACOs qualified for Medicare bonuses.

To read a FierceHealthcare report on ACO issues, please hit this link.

To read a Health Affairs post on ACO performance, please hit this link.

To read The New York Times’s story on this, please hit this link.


Big N.H. population-health project announced

Modern Healthcare has just reported:

“Dartmouth-Hitchcock Medical Center, Elliot Health System and Frisbie Memorial Hospital will jointly own a new company with Harvard Pilgrim Health Care that will share clinical information and financial risk for 80,000 New Hampshire residents.

“The joint venture, called Benevera Health, will bring together financial and clinical data to give the partner providers access to analytics that can help them manage care for all of the New Hampshire members in Harvard Pilgrim’s fully insured plans.

“The organizations’ executives said Monday they would make significant investments in technology to support the effort. Premiums for Harvard Pilgrim members will be 4% lower than they would have been without the venture, they said.”

Harvard Pilgrim CEO Eric Schultz said in a press release:  “The goal is to vastly improve patient care in New Hampshire by injecting personnel and new technology that will provide doctors and other clinicians with the information they need to help their patients make the best choices about their healthcare.

 

 


A way to reduce unnecessary transfusions

 

Pathologists at Dartmouth-Hitchcock Medical Center, in Lebanon, N.H.,  seek to reduce  unnecessary blood transfusions for non-bleeding patients by adding a “best-practice alert” in the patient’s EMR.

 

“We figured out how to harness the power of the electronic medical record to embed evidence-based transfusion criteria into the computerized physician order entry process through the best practices alert functionality,” Nancy Dunbar, M.D., who led the project, said.

 


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