ACOs have abil­ity to ID high-uti­liza­tion pa­tients

Modern Healthcare - - COMMENT -

Re­gard­ing the re­cent story “Re­form up­date: 1% of pa­tients ac­count for 22.7% of spend­ing, AHRQ finds” (Mod­ern­Health­, Oct. 8), ac­count­able care or­ga­ni­za­tions are one of the mod­els cur­rently be­ing tested by the CMS that can help ad­dress the is­sue. In highly or­ga­nized ACOs, doc­tors have ac­cess to a va­ri­ety of cost-of-care data, thus we are able to iden­tify those pa­tients who are overuti­liz­ers of emer­gency de­part­ments and hos­pi­tals. We can follow the pa­tients closely and as­sign care coaches and case man­agers. We have in­cen­tives to do home vis­its for those frag­ile Medi­care pa­tients not able to make it on time to the doc­tor’s of­fice. We call them of­ten to make sure they are tak­ing their meds. Pa­tient-cen­tered med­i­cal home struc­tures in our prac­tices help in the foun­da­tion of a ro­bust care-co­or­di­na­tion pro­gram. Dr. Jose Pena Donna, Texas

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