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United Medical Accountable Care Organization (UMACO)
Presented by Kyle Bain Changing the Behavior for Efficient Population Health Management
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United Medical Community Model
Hospitals CCHS Bayhealth St. Francis Beebe United Medical Network ~ 150 Providers DHIN Labs LabCorp Quest Advanced Surgery Cardiology Dermatology Family Practice Gastroenterology Hospitalists Internal Medicine Nephrology OB/GYN Ophthalmology Optometrist Pediatrics Psychiatry Physical Pain & Rehab Podiatry Pulmonary Disease Radiology Rheumatology Sports Medicine Urology Other DHIN Organizations Changing the Behavior
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Primary Care Physicians
One Patient – One Chart Hospital A Hospital Z Patient Demographics Progress Notes Medications Allergies Immunizations Past Medical History Primary Care Physicians Cardiologists Patient’s Chart OB/GYN Surgeons Other Specialists Labs & Radiology Changing the Behavior
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Unite Medical ACO Accountable Care Focus Points Main Focus
“To be Accountable for the Care of Patients” Improve Patient Care Improve the health of Populations Reduce Total Cost of Healthcare Methods Preventative Care Hospital Admission and Readmissions Screening Routine Medications Report to Electronic Health Records Changing the Behavior
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Benefits of an ACO Improve Patient Care
View and monitor full cycle of Patients Care. Primary Care Provider Specialists Specialist order cancer screening test Primary Care Provider is notified about the result (or lack of) More efficient way to monitor patient’s health Focus shifts to Preventative Medicine EHR lets Physicians run reports on Patient’s without Follow Ups or Tests Changing the Behavior
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Reducing the Cost of Healthcare
Medications Generic v Brand Name EHR allows to find Alternative medications Saves patient money and docs office saves time 2. Hospital Admission and Readmission Extremely Costly Professional Fees Facility Costs and Fees Solution Nurse Triage More Efficient Follow UP Changing the Behavior
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30 Day Readmission Cost Study
Estimated # of Total Readmissions in 12 months ,437 Average Length of stay (4 days: 5437*4) ,748 # of Total Discharges ,437 Total Encounters-Days ,622 Average payment per encounter $ 80.00 Total Payment for professional Services $ 2,609,760.00 (=32,622*80.00) Total Payment for Hospital Stay $ 150,789,758.00 (=5,437*27,734.00) This Estimate study does not take the reduction on the initial admissions in consideration but only focuses on 30 day Readmissions. Changing the Behavior Changing the Behavior
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Questions? Changing the Behavior
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