Pratt: Hospital ups traditional Medicare population service

Published 12:03 am Wednesday, January 17, 2018

The aging population is currently at its highest level in history.

As our community ages, healthcare costs rise, but what if there was a way to improve the quality of care for aging patients while simultaneously decreasing healthcare costs?

According to the Centers for Medicare & Medicaid Services, this is precisely the goal of an Accountable Care Organization, and we are excited to announce that St. James Parish Hospital is now on board.

What is an ACO?

Accountable Care Organizations (ACOs) — a new model of care made possible by the Affordable Care Act — are groups of doctors, hospitals and other healthcare providers who come together voluntarily to give coordinated, high-quality care to the Medicare community they serve.

Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, with the goal of avoiding unnecessary duplication of services and preventing medical errors.

When an ACO succeeds in delivering high-quality care and spending healthcare dollars more wisely, it can share in the savings it achieves for the Medicare program.

How We Are Improving the Quality of Care

We implemented several initiatives as we transitioned to an ACO to better manage the care of traditional Medicare patients (without advantage plans).

We hired Care Coordinators to establish long-term relationships with Medicare patients and have been contacting qualifying patients to help them take advantage of their free annual wellness visit, which allows our Care Coordinators to monitor their health over time.

We also implemented patient satisfaction and outcome-based goals in our clinics, which measure not only the patient experience but also the effectiveness of treatment.

Benefits of an ACO

• Patients with chronic conditions have a healthcare team that works together to care for them.

• ACOs improve communication and coordination between different providers, reducing admissions and keeping people healthier.

• Doing the right thing for the right reason saves money and results in a better patient experience and better clinical outcomes.

• Caregivers of patients with chronic conditions can have peace of mind knowing a multidisciplinary care team is working together to care for their loved one.

• ACOs do not restrict patient choice. There are no HMO or managed care restrictions.

St. James Parish Hospital — an ACO — is proud to voluntarily join an initiative that will help us better care for our traditional Medicare population while also holding us accountable for the quality of care we provide.

We look forward to continuing on the journey to improve care delivery, improve health and reduce healthcare costs.

Mary Ellen Pratt is St. James Parish Hospital CEO. She can be reached at info@sjph.org.