The healthcare world is spinning so fast, it’s making doctors feel sick.
Volume-to-value. MIPS and MACRA. APMs. Then Advanced APMs. Now QPP. The Center for Medicare & Medicaid Services introduces alternate payment models faster than the spread of last year’s flu outbreak.
Doctors are understandably focused more on their patients than the rapidly evolving world of value-based arrangements. But it’s important to remember that the CMS Innovation Center was designed as a way “to test models that improve care and better align payment systems to support patient-centered practices.” Rapid change based on learning is baked in to their model.
Release. Evaluate. Revise. Repeat.
One of those models that has stood the test of time is the Accountable Care Organization (ACO), groups of doctors, hospitals, and other healthcare providers, who collaborate to delivery high quality, coordinated care to the Medicare patients they serve. Coordinated care helps ensure that patients, especially the chronically ill, get the right care at the right time, in the right care location. When an ACO succeeds in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.
Arizona Care Network started as an ACO.
This Medicare “proof of concept” and the savings generated under these value base arrangements caught the attention of commercial payers, who developed their own versions. According to Healthcare Finance News, “For the first time, commercial lines rather than government lines of business are leading adoption, advancement, and innovation of value-based care models and strategies.”
Architects of a new, more effective healthcare system.
With many new commercial value-based arrangements available, ACN forged agreements with a variety of payers to give a broader population of patients the opportunity to benefit from value-based medicine. When this takes place outside of Medicare, the model is referred to as Clinical Integration.
So Arizona Care Network is also a Clinically Integrated Network (CIN).
Clinical Integration programs have proven to improve quality outcomes and slow the rising rate of healthcare costs. As a CIN, we provide data, tools, services and resources to our participating providers so we can improve the health of our community, manage the rising cost of care, improve the patient experience and drive provider satisfaction.
Since our inception on 2013, ACN has saved more than $40.5 million in total medical costs against the benchmark of members not managed under a value-based contract.
The Value of Joining ACN
Over 5,500 Arizona Care Network (ACN) providers help manage care for nearly 300,000 lives in the greater Phoenix area.
As an accountable care organization (ACO), ACN takes a collaborative, evidence-based approach that allows physicians to focus on what they do best – improving the health of their patients.
ACN is a physician-governed organization and is uniquely structured to allow providers to maintain their independence while giving them the opportunity to leverage shared resources, technology and support that will prepare them for the future of healthcare delivery.
When an ACO saves money on medical costs (while maintaining certain quality measures) the payer – government and/or commercial – shares a percentage of those savings with the ACO, based on the value-based agreement. Arizona Care Network then shares a portion of its savings with network providers.
ACN also created a rewards program for eligible primary care providers. This program offers additional incentives to primary care providers who coordinate care with ACN specialists and meet certain quality measures.
ACN providers receive access to new patients via inclusion on various commercial, government (Medicare/Medicaid) and direct-to-employer contracts.
Keeping a patient’s care in-network is one of the most efficient ways to reduce medical costs. ACN incentivizes primary care providers to refer to other specialists and ancillary services within the network, which generates additional patient traffic for those providers.
For a provider to deliver the highest quality care, there are certain technology resources they need. Unfortunately, smaller practices don’t always have the staffing or budgetary resources for these advanced technologies.
ACN supplies the following technologies at no cost to the provider:
ACN’s Care Coordination team assists providers by performing various population health activities to ensure patients have timely visits with their primary care provider and receive additional care from in-network providers, which helps prevent unnecessary utilization of costly emergency department and hospital services.
By joining ACN, providers receive a Clinical Performance Representative who helps practices review patient data and identify care gaps to meet quality metrics and maximize incentives.
Interested in joining ACN?
We are currently accepting new provider applications.
Get more information on the process of joining Arizona’s best care network and help us build a better state of care.