Problem
Accountable care organization (ACO) is an effort that focuses on support for Medicare patients, to ensure that these patients, especially the chronically ill, receive the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.
Hancock Regional Health (HRH) has taken on the responsibility of becoming an ACO. Part of the ACO effort is to know and understand all the care their ACO patients receive, no matter where they receive it, so they can provide support to reduce preventable hospital readmissions, for example.
When an ACO succeeds in delivering high-quality care (as in reducing hospital readmissions) and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
Solution
One of the most effective ways that ACOs can help manage their patients is to receive an alert when one of their patients is admitted or discharged from an emergency department visit, or is transferred to another facility as a result of an ED encounter. IHIE has partnered with HRH to send them ADT alerts for their ACO-related patients. With its network of over 100 hospitals, IHIE is able to cover most of the emergency encounters in Indiana. Once a month HRH will send IHIE their list of ACO patients, and IHIE matches those up with emergency encounters. These encounters are sent on a daily basis to the hospital IT team so that HRH can alert the specific practice associated with that patient. This notification enables the physician practice to contact that patient for follow-up support. Additionally, IHIE provides a readmissions report for patients who where readmitted to the hospital within 30 days of the original encounter.
