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N.J. ACO’s success linked to PCMHs, nurse coordination

 

Results have varied a lot across America for Medicare Accountable Care Organizations in their efforts to  save money and improve clinical outcomes. One that has done well is a New Jersey Medicare ACO that saved money and boosted care for two years in a row  while focusing on high-risk patients, says a study published in the American Journal of Managed Care.

The Hackensack Alliance Accountable Care Organization  had fewer readmissions and admissions and lower emergency department use, compared to a similar ACO group.  The organization also had far more patient office visits, which improved outcomes across the board, particularly for patients with chronic conditions.

The ACO reported shared savings of $5.6 million in the first year and $2.8 million in the second year.

The authors cited two big things for the successes:

  • An initial requirement that its physician practices be certified as patient-centered medical homes (PCMHs), which meant that physicians  understood what is required within a value-based care system.
  • Nurse  coordination  for patients at high risk for readmissions.

The authors of the study wrote: “We should emphasize that we do not change physician practice, we change physician behavior. By creating the appropriate interventions, we eliminate waste in our bloated healthcare system. We learn to address patient needs better. Although we are still good at disease management, we learn how to perform health management better from the PCMH model.”

To read the study, please hit this link.


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