By Ben Rodgers
GREEN BAY – Bellin Health was recently recognized as tops in the nation for blazing a new frontier when it comes to helping patients and saving money.
The Green Bay-based health care provider’s Accountable Care Organization (ACO) has achieved the highest overall quality score and lowest cost of care per patient among all Next Generation ACOs for 2017, the Centers for Medicare and Medicaid Services (CMS) recently announced.
“We consider ourselves an Accountable Care Organization and really what that means is as the health-care delivery system, we feel we have the best opportunity to help patients reach their health care goals,” said Dr. Brad Wozney, Bellin’s medical director for Population Health.
Wozney, who splits time between Green Bay and seeing patients in Denmark, said Bellin works through the Institute for Healthcare Improvement’s Triple Aim, which is a balance of quality of care, patient satisfaction and cost.
Wozney compared it to a three-legged stool – you can’t have two of the outcomes without having all three.
Like peeking under the hood of a vehicle, not everyone understands what makes this system work.
“From a patient side, the patients don’t notice the difference, but what we’re doing as a system, take my patient panel for example, all the people that come and see me. My team is keeping track of my entire population of patients, looking at a whole host of quality measures, clinical measures and patient satisfaction to make sure we’re trying to do as much as we can to get people to their health care goals and to practice evidence-based guidelines,” Wozney said.
From 2012-2015 Bellin participated in CMS’s Pioneer ACO Model through a collaboration with ThedaCare known as Bellin-ThedaCare HealthCare Partners.
Now, with Bellin as an ACO using the Triple Aim, it joined the CMS Next Generation ACO in 2016, and out of the 44 Next Generation ACOs was rated tops for 2017.
In 2017, Bellin generated more than $6.3 million in savings to CMS and scored a 98.36 percent for quality, based on 33 quality measures set by CMS.
Wozney said the emphasis is on planned care instead of critical care.
Planned care is where a person with conditions has planned goals and checkups to monitor those goals.
Critical care is when those conditions get so out of hand that drastic action is required.
“That’s where being an ACO is a leap and it’s a leap a lot of organizations don’t want to do because there’s a lot of up-front time and resources we have to spend internally for outcomes that might not be seen for five, 10 or 20 years down the road,” Wozney said.
The Next Generation ACO is an initiative from the Centers of Medicare and Medicaid Innovation, under CMS.
Participating health organizations have a set dollar amount they are expected to spend for the population they serve.
Those who go over that amount need to write a check to CMS, those under get to keep 80 percent of that to improve their care.
At Bellin this has allowed for the hiring of additional registered nurses and electronic medical records, which in turn helps with the Triple Aim.
“CMS is listening to what we’re saying here in Northeast Wisconsin on how to take care of patients better,” Wozney said. “CMS is hoping if they can spread a model like we do across the country, you can just image the results and cost savings they’ll get.”
But it wasn’t always like this. Wozney started practicing in 1998 and things were different.
“Probably the biggest difference that I’ve seen is the amount of information that we’re putting in front of physicians, physician assistants and nurse practitioners is significantly more than they ever had before,” he said. “Some of that are the benefits of having electronic medical records vs. being on paper. But we have all this information so I don’t have to rely on my patients telling me everything that’s been happening to them, or remembering everything that’s happened to them or remembering their last tetanus shot or mammogram.”
Another big change Wozney sees in the emergence of telehealth, where patients can consult a specialist over a camera on the home computer.
This cuts down on travel for both while saving money, and allows for more comfort for the patient, instead of having to endure great distances to see a specialist. These are all things that play into the Triple Aim and create an effective ACO.
With an eye on the future of health care and proven results behind him, Wozney said the innovation comes from the culture of Bellin.
“It’s our organizational mindset,” he said. “Our system has always been one that likes to push the edge on innovation. We’re never satisfied with the status quo, so it really fits the culture and the vision our organization has.”
Results aside, Bellin still wants to focus on helping every patient it sees.
“We’re pleased with our cost and quality metrics, but at the end of the day it’s about how we’re able to better coordinate care for our patients,” said Naomi Wedin, Bellin Health Partners executive director. “We’ve learned so much through our participation in these programs and we look forward to applying these lessons for the benefit of every patient we serve.”