TORRANCE, Calif. (June 1, 2015) — HealthCare Partners, a division of DaVita HealthCare Partners, is pleased to announce it has produced $1.8 million in savings as a result of its participation in the Enhanced Personal Care program (EPHC), a commercial Accountable Care Organization (ACO) formed by Anthem Blue Cross (Anthem). These savings were achieved from July 1, 2013 through June 30, 2014, EPHC’s first performance year.
The EPHC
program focuses on fully insured PPO members with two or more chronic
conditions, which research shows can most effectively be helped by coordinated
care. While these members can see physicians outside of the ACO, HealthCare
Partners offers access to a personalized health team that includes a doctor and
access to the HealthCare Partners ACO Unit.
“HealthCare Partners and Anthem have again proven that a commercial ACO
can be effective if focused on meeting high quality and utilization outcomes,
regardless of the reimbursement model,” said Dinesh Kumar, MD, chief medical officer,
HealthCare Partners California. “This trusted model of care continues to
promote an efficient and coordinated approach to our patients with complex care
needs, further encouraging medical and financial transparency.”
The
HealthCare Partners ACO Unit’s dedicated staff of care managers and care coordinators
conduct health risk assessments, identify hospitalized ACO patients, coordinate
transitions of care, and ensure patient care and healthcare resources are
accessible. In addition, HealthCare Partners extends medical management
programs to EPHC program patients, such as disease management, specialized high
risk programs, home care, and palliative care programs.
The $1.8
million savings were driven by meeting 100% of the quality measures, which
included preventive screenings for breast cancer, and enhanced management of
chronic diseases such as diabetes and heart disease as measured by the
nationally recognized Healthcare Effectiveness Data and Information Set
(HEDIS). Additionally, HealthCare Partners improved utilization metrics by
reducing hospital admissions and average length of inpatient stays, plus it
increased generic prescription rates.
Some of the
notable quality scores achieved by HealthCare Partners in the EPHC program, as
measured against the HEDIS benchmarks are listed below:
Quality Measures
|
HealthCare Partners Baseline Rate*
|
Anthem Quality Benchmark
|
Diabetes nephropathy screening
|
94.83%
|
84.16%
|
Cholesterol mgmt. for heart disease patients
|
92.41%
|
82.22%
|
Breast cancer screening
|
100%
|
70.20%
|
Pharyngitis appropriate testing/pediatrics
|
80%
|
69.38%
|
*Based on
Anthem average of 42,000 members for the performance period.
According to
a report from the University of California, Berkeley School of Public Health,
there are approximately 700 ACOs in the United States. California leads the
nation with 67 ACOs, a number that has more than doubled since August 2012.
HealthCare Partners is the largest commercial ACO in California.
About HealthCare Partners
HealthCare Partners, LLC, a division of DaVita
HealthCare Partners, manages and operates HealthCare Partners Medical Group
along with organizations in Nevada, Florida, Arizona, New Mexico, and Colorado.
HealthCare Partners Medical Group has been named a top-performer by the
Integrated Healthcare Association (IHA), and has been recognized by health
plans and business groups for medical leadership, the high quality of medical
care delivered, operational effectiveness, and high rates of patient
satisfaction. The organization includes more than 1,800 employed and affiliated
primary care physicians and more than 4,500 employed and contracted
specialists. In California, HealthCare Partners cares for patients in Los
Angeles, Long Beach, South Bay, Pasadena/San Gabriel Valley, San Fernando and
Santa Clarita valleys, and Orange County. In addition to primary care doctors'
offices, HealthCare Partners provides medical services through urgent care
centers, and offers a wide variety of support programs such as 24-hour
telephone support, electronic medical records, free or low-cost health
education classes, and special programs for chronic conditions. For more
information, please visit www.healthcarepartners.com
Contact Information
Media:
Diane Suzuki
562-293-1244
DSuzuki@healthcarepartners.com