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July 5, 2018

ACO roundup: Highmark's value-based PCP program saves $260M

Daily Briefing
    • Highmark's value-based PCP program saves $260M. The True Performance program—a value-based program that Highmark, an affiliate of Blue Cross Blue Shield, launched in 2017—has saved $260 million in health care costs, according to Highmark. The insurer said the program cut ED visits by 11% and inpatient admissions by 16%, saving $38 million and $224 million, respectively, over the course of a year. The program is designed to provide primary care physicians with the data, personalized support, and tools necessary to coordinate care for patients and manage population health.

    • How Mount Sinai dramatically improved outcomes via Hospital-at-Home—and 4 ways you can do it, too. Patients treated in Mount Sinai's Hospital-at-Home (HaH) program had better outcomes on certain measures than patients treated in the hospital setting, according to a study in JAMA Internal Medicine—and given the program's success, CMS is considering turning a version of HaH into a Medicare payment model, Maria Castellucci reports for Modern Healthcare. Under Mount Sinai's program, the hospital sends eligible patients home to receive acute care services from a team of physicians, nurse practitioners, and nurses for 30 days—the "post-acute period." The researchers found that HaH patients, when compared with the control group, had lower 30-day readmission rates and 30-day ED revisits rates, and were more likely to report the highest overall rating for care in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCHAPS) survey. Advisory Board's Tomi Ogundimu outlines how your organization can achieve similar success.

    • National coalition of large businesses launch bundled payment network. The National Alliance of Healthcare Purchaser Coalitions, a national network of business organizations, announced a partnership with Remedy Partners to form a national payment platform to encourage U.S. employers to shift from fee-for-service medicine to bundled payments. According to officials for the organizations, the platform aims "to develop a nationwide approach to bundled payments for surgeries and other procedures."

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    • The 2018 MIPS cost category—decoded. Join us on Thursday, August 2, at 3:00 p.m. ET, to learn the metrics included in the 2018 MIPS cost category, how providers' scores will be calculated, and strategies for improving performance.

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    • How to succeed under Medicaid risk. Join us on Tuesday, August 14 at 1:00 p.m. ET for a live panel discussion with population health, health plan, and Medicaid strategy experts from within Advisory Board to learn about key considerations for taking on Medicaid risk and setting up the right infrastructure to manage the population.

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