Value-based care works for small, independent primary care practices. And now, thanks to some stellar 2019 results, we know it works for health centers, too.
Our West Virginia federally-qualified health center (or FQHC) ACO proved it. Back in 2017, Aledade and a group of 10 FQHCs across the state of West Virginia joined together to form an ACO. It was a new step for Aledade, and for these health centers. Health centers, or FQHCs, are groups that provide community-based, comprehensive, integrated primary care to a wide range of patients. They care for everyone - Medicare beneficiaries, Medicaid, Medicare Advantage, private health insurance, and many of the uninsured. They serve as the essential health care safety net for communities across the country.
At Aledade, we started our work with small, independent primary care practices, so we quickly realized that working with these larger, more complex organizations would require some tweaks to our original tools if the data we were providing was to be actionable to the FQHCs. The health centers realized that they’d be receiving a wealth of new data from Aledade - data that would be extremely valuable in caring for the patients in their community.
So we got to work. For the next two years, we worked as partners, building and improving the data delivery at the site level. We wanted to make sure that health centers had pertinent information for their patients, right when they needed it. We worked on interfaces so that these providers could get real-time, patient-level information to help them care for their patients. We helped these health centers identify who on their team would own the care management and quality aspects of our initiatives and built the workflows that they would use to optimize patient care. The data is good. Actionable data that goes into a thoughtfully-designed workflow is better.
By 2019, we started to see promising results. So we started to grow. Since we were confident in our efforts, we decided to add 7 additional FQHCs in West Virginia to the ACO. Our plan was to get the new health centers “up to speed” during 2019 and move to our second contract in 2020.
That’s when the federal government threw a curveball. CMS announced that there would be no new starts for ACOs in 2020. In our ACO alone, 41 percent of our health centers were brand new to the ACO world. We had a decision to make. We could extend our original contract or we could move to a new contract in July of 2019. We could even move to a new contract, with more risk, in July. In other words, we could play it safe, or we could make a big bet that we had figured out the way for health centers to succeed in value-based care.
“Would that be crazy?” we asked ourselves. Some of the new health centers were really only getting started with things. So we took a close look at the progress we had made together. We consulted with the teams at these health centers, and we all felt confident that we could do it. We had tailored our product and processes for these larger multi-site organizations. The teams at the health centers were utilizing the data to optimize visits and quality outreach. As a group, we decided that everything was in place for us to be successful. We were ready. We chose to go to risk in July.
And the results speak for themselves. We saved Medicare more than $9 million, by providing better care to more than 28,000 patients. We helped these health centers achieve a score of more than 92% on their quality metrics and reduce inpatient admissions by 7%.
Every single one of Aledade’s health center ACOs in 2019 earned shared savings in the Medicare Shared Savings Program.
I am so glad we bet big on health centers, and went to risk. Health centers are perfectly positioned for value-based care - they’re already focused on keeping their patients healthy, despite challenging circumstances, and moving to value-based care finally reward them for that work. I am so thankful for the partnership that I have with this group of health centers and I look forward to continued success to our ACO as they continue to provide great quality care for their patients and their communities.