Osler Health is an IPA transformed ACO based out of New Jersey. A clinically integrated network of over 200 providers, Osler Health has over 42 different practice locations for a panel of 350,000 patients.
Osler Health decided to participate in the CMS MSSP program to adopt a value-based approach by transforming into a leading ACO. The key challenges they addressed were:
- Unification of data from different sources including 13 different EMRs
- Deriving insights from data to meet the triple aim of better outcomes, better patient experience, and lower costs
- Understand utilization metrics and thereby drive efficiency
By consolidating data from disparate sources using a unified healthcare data platform, Osler Health integrated data from 27 practice sites in record time. The key achievements were:
- Highest quality reporting data for shared savings program in the state of New Jersey
- 20% more in shared savings
- First 2% of record quality data in New Jersey
The application for an ACO was approved by the CMS in 2017.
Here’s the complete journey:
The evolution of healthcare: An IPA perspective
Healthcare needs physicians to stay independent. Working in an organization, they would want to have full transparency and readily available actionable insights. With HIPAA regulations and meaningful use guidelines, IPAs need unified platforms for uniform data representation throughout the network. Decreased reimbursements and constant emphasis on value-based care have pushed down IPA top-line. They are now aiming to turn into ACOs as they have a much tighter structure and generate revenue while promoting value-based care.
With only a little over 30% of ACOs generating savings, it can be said that many healthcare executives at ACOs are still evolving with the ongoing transitions to value-based care.
Challenges in becoming an ACO
The key difference between an IPA and an ACO is healthcare discipline and governance. IPAs struggle with inefficiencies and improper utilization management due to the lack of structure and technology.
Since the passage of the Affordable Care Act, there’s a focus on accountable care organizations (ACOs) to drive value in care by leveraging the available data. This is aimed at enabling community-wide care assessment and coordination, including functional integration of electronic health records (EHR) with other data coming from different care settings of the network. ACOs also need to have defined processes to promote value-based care. For this, everything ACOs do is in accordance with the standardized clinical protocols of the value-based contract.
The challenges imposed by the complexity of data silos call for the integration of a network’s practices to drive efficiency across the care continuum. All in all, transforming to an ACO is a huge undertaking. One that requires the right strategy to not only bring all the data together but also the team; despite the geographical barriers.
Evolving into an ACO using unified healthcare data platform
New Jersey-based Osler Health is one such network that stepped into the Medicare Shared Savings Program (MSSP) and took its first step in the direction of accountable care. With 200+ physicians from over 40 locations, the IPA strategically implemented MSSP Track 1 across 13 of its practices this year.
The learning curve of transitioning from an IPA into an ACO is a steep one, and the first thing that Osler Health needed to do was to create a data infrastructure. The data infrastructure had to be robust enough to not only consolidate data but also allow physicians to access critical information at the point of care. The network leveraged Innovaccer’s healthcare data platform to integrate critical data for over 350,000 lives, coming in from 14 different kinds of EHRs.
The unified healthcare data platform integrates healthcare data for Osler Health’s patients into longitudinal records. This has allowed the providers to identify the at-risk patients, stratify them as per the need, make assessments for care interventions, and maintain the continuity of care. All these records are updated frequently for Osler Health and are accessible to providers on customizable dashboards. These insights provide physicians with an assessment of their patient panel across key quality measures.
A significant number of Osler Health’s strategies were supported by data-driven approaches. Even before Osler participated in MSSP Track 1, they were able to generate the highest quality reported data for shared savings program in the state of New Jersey.
“As an advanced value-based care provider, our analytic capabilities are the key to our success,” said James Doulgeris, Osler Health’s CEO.
The key for organizations to master the ongoing healthcare transformation is to reiterate their strategy with the evolving needs of payment models. What was needed 10 years ago, might not be relevant today. Similarly one needs to keep on innovating to be future-ready. Practices need sophisticated IT infrastructure that separates value from mountains of data and leads the change with actionable information.
Read more about Osler’s collaboration with Innovaccer on the data-driven front here.
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