Holston Medical Group Demonstrates Actionable Analytics at AMGA IQL Conference
HMG shares program that led to a savings of $23 pmpm and stresses that providers must stay ahead of the cost curve in order to succeed.
Scottsdale, AZ November 12, 2013 - Holston Medical Group (HMG) presented four principles for putting analytics into action at the American Medical Group Association’s Institute of Quality Leadership Conference (AMGA IQL) in Scottsdale, Arizona on Thursday, September 26. Wendy Oberdick, MD, Medical Director for HMG’s Patient-Centered Medical Home and HMG’s Value-Based Operations, and Jason Tipton, MBA, Director of Informatics for HMG, presented a detailed plan for each principle: (1) stratifying your patient population, (2) developing your data assets, (3) creating care resources, workflows, and processes to support performance, and (4) measuring compliance.
Over a period of 30 months, HMG has reduced the number of hospital admissions per month by 20% among Medicare fee-for-service patients and by 28% among Medicare Advantage and commercial patients. For commercial contracts, HMG is 3.2% better than market in quality performance, 8.1% better than market in total medical cost, which represents a savings of $23 per member per month. Oberdick and Tipton have front-line experience managing accountable care organization (ACO) risk contracts in their additional roles with Qualuable Medical Professionals, an ACO participating in the Medicare Shared Savings Program (MSSP). Achieving these levels of performance required clinical analytics to more accurately understand each patient’s needs than had been possible using claims data alone.
According to Oberdick, “To truly achieve our desired outcomes, we knew that ‘running the gaps’ was not enough. We needed to stratify our patient populations in a meaningful, impactful manner. Only then were we able to deploy the right resources for the right patients.”
HMG shared their re-engineered workflows and how they are using analytics to sustain return on investment via fee-for-service while driving efficiency and achieving their metrics for value-based contracts.
HMG uses Humedica MinedShare as a key component to understand and stratify their population. Additionally, this tool is used in their workflows to worklist patients and for cohort reporting. As a participant in AMGA’s Anceta Collaborative, HMG addressed three themes that have emerged: the composition of care teams, changes in workflow and how members of the care team interact, and actionable data displays.
As Tipton observed, “What we do today will not get us to tomorrow. We need a paradigm shift.” Realizing this, he said, set the stage for transitioning from a reactive “sick model” and use of claims data reflecting past expenditures to a proactive wellness model that begins with understanding gaps in care, with clinical detail.
The American Medical Group Association (AMGA) is a 501(c)(6) trade association representing medical groups, health systems, and other organized systems of care, including some of the nation's largest, most prestigious integrated delivery systems. AMGA is a leading voice in advocating for efficient, team-based, and accountable care. AMGA members encompass all models of organized systems of care in the healthcare industry, including: physician-owned, independent group practices, integrated delivery systems, hospital-affiliated medical groups, independent practice associations (IPAs), academic and faculty practices, accountable care organizations, and high-performing health systems. More than 130,000 physicians practice in AMGA member organizations, providing healthcare services for 120 million patients (approximately one in three Americans). Headquartered in Alexandria, Virginia, AMGA is the strategic partner for these organizations, providing a comprehensive package of benefits, including political advocacy, educational and networking programs, publications, benchmarking data services, and financial and operations assistance. www.amga.org
AMGA's Anceta collaborative extends the tradition of shared learning among AMGA member organizations. Using Humedica's unique clinical analytics platform, Anceta facilitates data-driven collaboration to enhance value in population health. Anceta and Humedica illuminate the relationships between care process, patient outcomes, and cost—all the elements of the value equation.
The American Medical Group Association's Institute for Quality Leadership conference is devoted to improving the quality of care delivered in the U.S. healthcare system through advancement of knowledge and education of healthcare professionals. This year's IQL focused on finding real-world solutions to the growing challenge of managing the total cost of care.
Humedica, an Optum company, is the foremost clinical intelligence company that provides private, cloud-based solutions to the healthcare industry. Humedica’s sophisticated analytics platform transforms clinical data from disparate sources into actionable, real world insights. Powered by the nation’s largest and most comprehensive clinical database, Humedica solutions offer a more complete, longitudinal view of the health of patients and populations. Through its award-winning solutions, Humedica, which is headquartered in Boston, empowers its partners and customers to make confident, value-based decisions about patient care in a rapidly changing health care market. For more information, visit www.humedica.com.
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