Making the move to an ACO.

Area of Science:

• Healthcare Management
• Population Health
• Accountable Care Organizations

Background:

• Crystal Run Healthcare, a multispecialty group, faced challenges in workflow, culture, and hospital partnerships for ACO success.
• Accountable Care Organizations (ACOs) require integrated care models to improve patient outcomes and manage costs.

Purpose of the Study:

• To evaluate the impact of an embedded care manager program within an ACO framework.
• To assess the effect of ACO participation on hospital readmission rates and healthcare costs.

Main Methods:

• Implementation of an embedded care manager program at a partner hospital.
• Analysis of 30-day all-cause readmission rates for Crystal Run patients.
• Evaluation of cost of care and quality metrics for specific patient populations, including diabetics.

Main Results:

• An 8% decrease in the 30-day all-cause readmission rate for Crystal Run patients at the hospital.
• A 15% reduction in the cost of care for the diabetic patient population.
• Improvements in quality metrics for other at-risk populations were observed.

Conclusions:

• An embedded care manager program within an ACO model can significantly reduce hospital readmissions.
• ACO participation enables cost savings in specific populations, such as diabetics, while enhancing overall care quality.
• Strategic partnerships and cultural changes are crucial for successful ACO implementation and value-based care delivery.