ACN Presents Checks for Aetna Gain Share and Provider Incentive Program | ACN to Expand Services for Mercy Care Plan Patients | Coming Soon: My AZ Doc 2.0 | ACN's Preferred Next Generation ACO Providers | PTX Spotlight: Influencing Patient Experience to Grow Your Practice | Joint Operating Committees Offer a Collaborative Path to Success | News Roundup | Welcome New Provider Organizations | Contacts
ACN recently delivered gain share checks to providers who saw patients in Aetna’s employer-sponsored commercial plans during the contract year ending December 31, 2016.
In total, ACN providers contributed to a medical cost savings of $2.6 million for this population. We share in that savings and, per board policy, are pleased to distribute half of the savings the network earned under this agreement among our providers.
Shared savings distributions are made at the TIN Level. The leadership of each medical group or practice determines their own internal distribution policies.
ACN also delivered final payout checks for the 2017 Provider Incentive Program (PIP). PIP checks are distributed quarterly to primary care providers based on MSSP and Next Generation ACO attribution. The incentive checks are based on clinical quality measures, net promoter score (NPS), and in-network utilization. The final payout reflects fourth-quarter data as well as all other 2017 “true-up” payments. Eligible ACN providers earned in excess of $1 million from the Provider Incentive Program over the past year.
For 2018, ACN has begun rolling out its new Provider Rewards Program, which refines the program to include a more efficient payment model and new clinical performance domains, including a greater emphasis on patient satisfaction (Net Promoter Score) and annual wellness visits.
Congratulations to all the providers and practices who have helped prove that high quality care is cost-efficient care.
ACN’s success in prior years resulted in a new value-based contract with Mercy Care Plan for Medicaid patients. The expansion means significant growth for ACN’s integrated care model.
Under the new contract, ACN plans to implement a greater clinical presence in three practices with high volumes of Mercy Care Plan patients. ACN selected Trinity Adult Medicine, which has approximately 300 Seriously Mentally Ill (SMI) patients, as the first site with the two other sites to be announced at a later date.
ACN will place a five-person team at Trinity Adult Medicine, working with Rodd Aking, MD. That team will include the following positions:
In this model, the clinic coordinator will oversee the ACN team and serve as the office liaison. The registered nurse will serve as the key point of contact for patients with complex medical conditions, and the behavioral health coach will serve as the key point of contact for patients designated SMI. The social worker will assist patients with necessary resources for home life and day-to-day living. Lastly, the medical assistant will ensure patients are up-to-date on their prescriptions and are scheduled for preventive health screenings such as mammograms and diabetic eye exams.
ACN members covered under Mercy Care Plan, especially those designated SMI, are some of the most vulnerable patients in our network. However, through an integrated care model, ACN and Mercy Care have been able to improve health outcomes at a lower cost of care.
Over a two year period, ACN was able to help patients break a harmful cycle and demonstrate measurable improvement in outcomes that cost $14.4 million less than the benchmark expected for the Mercy Care Plan population. We are excited to continue our work with Mercy Care Plan and make a difference in the lives of people who need it most.
ACN will release an updated version of its mobile app, My AZ Doc, in the coming weeks. The update includes a design refresh to match ACN’s new branding, which was launched earlier this year. The app will also include Spanish translation and icons indicating Phoenix Children’s Care Network providers.
"My AZ Doc puts more than 5,500 Arizona Care Network providers in 1,800 care locations at your fingertips. It’s one of the best ways to help patients find in-network providers and facilities, which can improve care coordination and reduce healthcare costs.," noted Bill Conati, ACN's new sr. director of IT.
Features within My AZ Doc include:
Please encourage your fellow providers and staff, as well as your patients, to download the app for instant access to ACN's full provider and facility directory.
For more information about My AZ Doc, please visit https://azcarenetwork.org/download-app/ or contact your provider network consultant.
In addition to primary care providers and specialists, ACN also includes a variety of ancillary services and facility provider organizations in its network. Enlisting the services of these providers supports ACN’s goal to improve clinical outcomes and reduce the prevalence and progression of disease. Patients who utilize these services also generally experience a lower total cost of care.
In an effort to streamline network utilization and provide efficient, coordinated care, several providers agreed to partner with ACN as preferred Population Based Payment participants in our Next Generation ACO, including:
Inpatient Rehabilitation Hospital
Organizations participating as Population Based Payment preferred providers agree to accept a reduced FFS reimbursement from CMS for services provided to ACN's Next Generation ACO beneficiaries. The savings generated through these arrangements are shared with ACN to support various care coordination, population health and technology resources the network deploys to meet the objectives of value based medicine. Over time, the cost savings generated through this arrangement will benefit the entire provider network. As an organization, we’re grateful for the commitment these providers have shown to the network.
This summer ACN will be providing opportunities for other providers to participate in this CMS program in 2019. If you need assistance locating a preferred ancillary service provider, please contact ACN’s Concierge Line at 602.406.7226 or your provider network consultant.
ACN emphasizes a positive patient experience for two reasons: It’s a critical component to MSSP and Next Generation ACO agreements, and it’s vital to your practice’s health and growth. By providing a positive patient experience, our members are more likely to recommend you to others, rate you positively on social media and surveys, and speak highly of you to their circle of influence.
If we all know how important this is, why is it so challenging to deliver on a consistently positive patient experience – one where patients are eager to recommend you?
It’s important to remember that the patient experience extends much further than the limited face-to-face interaction between the physician and the patient. It starts from the moment a patient learns about you, and each interaction influences their perceptions: online research, scheduling an appointment, interacting with your front desk, experiencing the waiting room, interacting with the care team, checking out, and even receiving the bill.
“Becoming a patient is disruptive and life altering… the luxuries of access, communication, control, service, emotional/physical well-being, and transparency erode. At a more profound level, becoming a patient challenges your identity. Your humanity,” says Dr. Adrienne Boissey, Chief Experience Officer for Cleveland Clinic. “So the opportunity lies in not only making sure we return these capabilities, but also in ensuring that our patients feel like human beings. Not an iPatient. Not a bed #. Not a disease.” [read more in the NEJM Catalyst]
For providers who see Next Generation ACO and MSSP members, find your patient experience report on ACN’s secure portal. For 2018, the Patient Experience domain of your Provider Rewards Program is now 10 percent, double last year’s metric. ACN has information and evidence-based tools to help you maximize the rewards of an excellent patient experience. Contact your CPR or email Quality@azcarenetwork.org.
With increasing complexity and variation in value-based agreements, ACN’s Clinical Performance Council decided to implement quarterly onsite Joint Operating Committees (JOCs). The council believes this is the best way to share data and help providers succeed.
To kick-start this initiative, ACN’s Clinical Leadership Team will visit all MSSP and Next Generation ACO primary care providers to review clinical performance data and establish action plans. To date, ACN has visited approximately 30% of all practices and is currently reaching out to the remaining TINs to schedule meetings in the upcoming months.
The initial JOC will focus on the following:
During the visit, ACN’s Clinical Leadership team will review practice-specific data including, but not limited to:
The data that you review during the JOC will be customized for your practice and measured against ACN’s average and the CMS benchmark. The goal is to leverage data transparency and collaboration to develop an action plan tailored to your practice to drive your success in value-based medicine.
Following the initial meeting, your Clinical Performance Representative will schedule monthly visits to help track your progress. If you are a MSSP or Next Generation ACO primary care provider and have not had a JOC, please contact your CPR or email Quality@azcarenetwork.org.
Questions about ACN? Email firstname.lastname@example.org or contact your Provider Network Consultant:
Central POD - Samantha Reichel
West POD - Lori Silverstein
East POD - Jonee Christensen
Southeast POD - Alena Camacho