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Each ACLC Case Study Brief (CSB) spotlights a single provider organization’s efforts in developing a specific value-based competency. Each CSB includes the following: important information about the provider organization (demographic and background context), its approach to the competency including any tools and vendor partners used, the results experienced to date, challenges and barriers, and key learnings. Contact information for contributors is also included. The CSB is a concise, two-page document created for health care industry executives to gain quick and important lessons that they can apply to their own organization.
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Case Study Brief Example: Title: Deploying a Patient Risk Stratification Tool to Inform Care Management - OneCare Vermont Provider: OneCare Vermont Background: OneCare Vermont is a statewide ACO comprised of a large and diverse provider network who together contract with numerous payer types, thereby covering a wide range of patients and populations. At the time of its inception in 2012, OneCare had been relying on the Hierarchical Conditions Category (HCC) risk adjustment model to estimate patient clinical risk and costs across the health system. However, in 2014 when the ACO entered into its first contract with Vermont Medicaid, it found that the risk adjustment model was insufficient for the new population of patients, particularly pediatric patients, as the HCC model was designed for the Medicare senior adult population. In order to most efficiently allocate resources across its diverse patient population and identify high-risk individuals who could most benefit from enhanced services, OneCare Vermont sought to utilize a risk stratification tool that would apply to all populations. |
Case Study Brief Topics:
Advocate Health Care, Creating a Culture of Engagement |
Allina Health, Engaging Physicians in the Design and Direction of a Clinically-Integrated Network |
Arizona Connected Care, Home-Grown Solutions for Tracking Total Cost of Care |
Ascension Care Management, Selecting and Supporting High-Value Leaders for Accountable Care |
Atrius Health, Developing a Real-Time Predictive Model for Identifying High-Needs Patients |
Centura Health, Building Custom Solutions for Real-Time Care Coordination |
Children's Hospital of Orange County, Standardizing Best Practices Through Care Guideline Integration |
Cornerstone Health Care, Designing an Extensivist Model for High-Needs Patients |
Facey Medical Group, Serious Illness Approaches by ACOs |
Hackensack Alliance, Starting Small to Save Big: Selecting and Sequencing Initiatives Wisely |
Henry Ford Health System, Relationship-Based SNF Collaboration |
Hill Physicians Medical Group, Engaging Physicians and Payers in Innovative Oncology Payment Models |
Illinois Critical Access Hospital Network (ICAHN), Developing a Quality-Reporting System for a Critical Access Hospital ACO |
Integra Community Care Network, Palliative Care Education for Care Managers in a Medicare ACO |
Intermountain Healthcare, Engaging Clinical Staff in Sepsis Detection and Intervention |
Lehigh Valley Health Network, Optimizing a Patient Portal to Increase Engagement |
MaineHealth, Developing a Quality Heat Map to Drive Cross-Contracts Quality Improvement |
MaineHealth, Serious Illness Approaches by ACOs |
Mayo Clinic, Generating Value by Integrating Palliative Care into Primary Care Workflows |
Memorial Hermann Health System, Defragmenting the Delivery System Through Quality and Contracting Alignment |
Mission Health, Utilizing Innovative HIT Partnership to Reduce Inpatient Falls |
Moffitt Cancer Center, Standardizing Palliative Care and Oncology Integration Using Assessments and Care Pathways |
Montefiore Health System, Leveraging Digital Technology to Improve Behavioral Health Integration with Primary Care |
MyHealth First Network, Utilizing Teams to Improve Transitions of Care |
New West Physicians, Accelerating the Adoption of Evidence-Based Practices |
New West Physicians, Creating a Physician-Led Value-Driven Compensation Model |
Northern Arizona Healthcare, Developing Partnerships to Strengthen Individuals and Communities |
NYC Health + Hospital, Serious Illness Approaches by ACOs |
OneCare Vermont, Deploying a Patient Risk Stratification Tool to Inform Care Management |
OneCare Vermont, Reducing Variations in Care through Transparent Data Reporting |
OSF HealthCare, Optimizing Technology and Staff for Advance Care Planning |
Park Nicollet Health Service, Leveraging Pharmacists in Ambulatory Care Teams to Optimize Medication-Related Health Outcomes |
Parkview, Developing a Paramedic Response Team to Support SNF Partners |
Pioneer Valley ACO, Leveraging Technology for Real-Time Care Coordination |
Presbyterian Healthcare Services, Serious Illness Approaches by ACOs |
ProHEALTH, Delivering Home-based Palliative Care within an ACO |
Sharp HealthCare, Providing Early Palliative Care Interventions for Patients with Serious Illnesses |
Signature Medical Group, Designing a Biopsychosocial Care Model for High-Risk Maternity Patients |
Signature Medical Group, Designing a Provider-Driven Platform |
St. Vincent's Health Partners, Designing a Communication Strategy for a Clinically Integrated Network |
Summit Medical Group, Designing a Self-Funded Rewards Program to Engage Physicians in Risk Adjustment |
Total ACO, Building Internal Quality Reporting Expertise |
U.S. Medical Management, Serious Illness Approaches by ACOs |
UT Southwestern, Designing Governance for Bottom-Up Innovation |
Vidant Health, Serious Illness Approaches by ACOs |