ACO’s Health IT, Care Coordination Improve Care, Lower Costs for Medicare Fee-for-Service Beneficiaries

Aetna and Bon Secours Health System (BSHSI) have launched a new accountable care agreement that will use technology and care coordination services from Aetna subsidiary Healthagen to help coordinate healthcare for Medicare beneficiaries.

The accountable care organization (ACO) will support 57,000 fee-for-service (FFS) Medicare beneficiaries in Kentucky, New York, South Carolina and Virginia, and whose primary physician participates in the Good Help ACO. The agreement is designed to improve the quality of care for Medicare beneficiaries under the Medicare Shared Savings Program (MSSP) while lowering overall healthcare costs.

In addition, Aetna will administer Bon Secours’ employee medical benefits plan beginning September 1, 2013. Bon Secours provides health benefits to 12,000 employees and their dependents.

Healthagen will provide Bon Secours with technology, analytics and care coordination staff to help physicians care for Medicare patients who need support for emerging and chronic health issues. The capabilities will complement existing Bon Secours technology, such as electronic medical records (EMRs), officials say. The solution will include the following:

  • Health information exchange technology for the secure, two-way exchange of health information across a patient’s entire care team; and
  • Desktop-based access to clinical decision support and workflow tools to help physicians track, monitor, coordinate and report on patient health outcomes.

By identifying the individuals who may benefit, the care team can offer clinical programs and health interventions to help prevent avoidable health issues, effectively manage those that exist and minimize the progression of chronic disease. The collaboration will have a significant focus on patient engagement and compliance to help ensure the long-term success of the overall effort.

The Centers for Medicare and Medicaid Services (CMS) sponsors the MSSP to utilize coordination and cooperation among providers to improve the quality of care for Medicare FFS beneficiaries and reduce unnecessary costs.

Source: Aetna , June 25, 2013

Guide to Accountable Care Organizations

Guide to Accountable Care Organizations lays the groundwork for an ACO program, delivering a comprehensive set of 2012 ACO benchmarks from 200 companies; a framework for clinical integration, a key ACO prerequisite that puts participating providers on the same performance and payment page, and much more.

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