Study by the Centers for Medicare and Medicaid Services
Since the U.S. Department of Health and Human Services introduced them in 2011, Accountable Care Organizations (ACOs) have demonstrated tremendous promise for both health care providers and the patients they serve. Designed to help contain out-of-control health care costs, ACOs work by coordinating care between providers so that patients – especially those who are chronically ill – get the right care at the right time while avoiding unnecessary duplication of services.
To date, ACOs have been a win-win for everyone. Patients receive better-coordinated care, providers are rewarded for delivering higher quality services, and Medicare saves taxpayers money. A study completed in 2017 by the Centers for Medicare and Medicaid Services (CMS) found that ACOs participating in the Medicare Shared Savings Program saved nearly $1 billion over three years.
The home health sector, in particular, has become an essential player in helping ACOs achieve their mission, especially when it comes to keeping patients healthy at home. Patients now depend on home health care for a variety of reasons: to recover safely at home after illness or injury, to manage a chronic condition, or to recuperate from a less-serious condition. Along the way, skilled teams of nurses, doctors and speech, physical, and occupational therapists work together to ensure that patients receive quality, coordinated care.
For an example of how a collaborative, hands-on partnership between a home health provider and a large health system is helping ACOs succeed, look to the Southwestern Health Resources Accountable Care Network, where providers from across the Dallas-Fort Worth area are coming together to streamline and coordinate care.
In 2012, LHC Group, a leading provider of home health care, partnered with Texas Health Resources to improve health care delivery for the system’s ACO patients, and today the joint venture cares for more than 300,000 ACO patients in the Southwestern Health Resources Accountable Care Network, including 87,000 who are Medicare beneficiaries. By partnering with hospital systems in this way, LHC Group can create enhanced value for both partners by allowing each to focus on what it does best. The hospital can double down on delivering acute-care services while the home health provider can work on establishing a direct pathway to care for patients after discharge. This joint venture relationship is a unique one that succeeds in giving patients what they want and need: care that helps them achieve the best possible health in the comfort of their own home.
Over the past several years, the LHC Group-Texas Health partnership has significantly reduced hospital lengths-of-stay, lowered the 30-day re-hospitalization rate and raised patient satisfaction scores – all of which help generate ACO savings. To date, nearly 20,000 home health patients throughout the North Texas region have benefitted from this new care coordination model, which internal data show is providing better care at a lower cost.
According to data compiled by Strategic Health Partners (SHP) in December, LHC Group was able to initiate home health services in a timely manner nearly 99 percent of the time – higher than the national average of 93.4 percent. Timely care initiation is critical, as the vast majority of referrals in the area are for patients being discharged from a hospital or other acute-care setting. Admitting patients within 24 hours of referral helps reduce re-hospitalization risks and enhance cost-efficiency.
In 2017, Medicare patients cared for by LHC Group providers experienced a re-hospitalization rate of 9.66 percent, compared with the national average of 12.31 percent, according to another SHP analysis. LHC Group also achieved a cost-efficiency per episode almost $2,000 less than the CMS national average, according to Medicare claims data. Effective relationships with health system partners has ensured that patients get what they need, when they need it.
These positive data points are evident in quality ratings. Last year, the Southwestern Health ACN was ranked seventh in the nation – having saved more than $73 million health care dollars over three years while maintaining a CMS quality score above 95 percent. For the past two years, LHC Group’s home health agencies in the area have maintained a 5-star quality rating from CMS.
Moving forward, the LHC Group-Texas Health partnership, along with the Southwestern Health ACN, will continue to acquire, grow and improve as more providers recognize the value of coordinated care. While the broader health care landscape may be in constant flux, the core objectives for providers never change: better care, higher quality, lower costs.
Keith G. Myers is the chairman and CEO of LHC Group Inc. of Lafayette, Louisiana, and Barclay E. Berdan is the CEO of Texas Health Resources.