Care Transformation Center Blog

How this German ACO became one of the world's most successful population health managers

by Tomi Ogundimu and Petra Esseling

This is the second blog in a series about care transformation around the globe, where we look at successful population health managers outside the United States. In this post, we highlight the successes of a German population health manager, Gesundes Kinzigtal.

This month's case study takes us to Kinzig Valley in Germany, where a partnership between a management company and a primary care network has significantly improved care and reduced costs for their community. The partnership is called Gesundes Kinzigtal, or "healthy Kinzig Valley." Since its creation in 2006, it has become one of the most successful integrated care organizations in the world.

To embark on this work 11 years ago, Gesundes Kinzigtal entered into a joint risk-sharing agreement with two private health insurers to manage their populations.

In 2014 alone, Gesundes Kinzigtal achieved about $6.7 million in cost savings for their insured population, compared with risk-adjusted normal costs of care in Germany. Savings are the result of reduced hospital days, reduced medication costs, increased life expectancy, and improved patient access.

How did they do it? Similar to many other United States-based ACOs, the foundation of the Gesundes Kinigtal care model rests on three interwoven elements:

1. Risk stratification and data analysis

The Gesundes Kinzigtal data warehouse includes insurer data on claims, diagnoses, services, prescriptions, and hospital admissions, as well as data from service partners. The system's analytics team uses this data to risk-stratify patients, predictively monitor and plan intervention programs to support patients' needs, and track quality and outcomes over time.

2. Enhanced primary care management

Patients receive care management support and are eligible for expanded access to preventative services outside typical business hours. PCPs are reimbursed for the costs associated with additional services and time they invest in care. For patients this means that they have access to short-notice physical therapy or behavioral health appointments, when out-of-network patients wait weeks.

3. Public health initiatives

Gesundes Kinzigtal provides health education in schools, holds cooking classes, and workshops on a variety of health topics. Additionally, they invested in a fitness and training center that's specifically geared towards the needs of the elderly. Each machine in the training center automatically adjusts to patients based on their physical build and care plan.


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