The Key to ACO Success – Peer Collaboration

Success within new Advanced Payment Models (APMs) such as the Centers for Medicare and Medicaid Services Next Generation ACO program (Next Generation ACO) requires a willingness to experiment and quickly adapt. Evolent Health founded its ACO Learning Collaborative to help our partners do just that. 

The ACO Learning Collaborative provides a monthly telephonic forum and a quarterly in-person forum for individuals from Evolent’s ACO partners to come together to share and learn about different approaches to improve clinical and financial performance. “We keep our discussions focused on sharing what’s working to drive performance, and learning how to adapt those approaches to different circumstances,” said Eric Fennel, Evolent Health’s SVP, Payer Partnership Solution Operations. “Our partners drive the conversation and have invested in helping each other be successful.”

Developing a collaborative environment, rather than a competitive one, has been an essential part of the ACO Learning Collaborative’s success. “The level of collaboration has been remarkable, and it’s only gotten better as we’ve gotten to know each other,” said Zack Menn, MSSP Clinical Program Director for Houston Methodist. For example, one of the members of the ACO Learning Collaborative, St. Luke’s Health Partners, had developed a SNF (skilled nursing facility) scorecard. They collected data from area SNFs, compiled important statistics on a scorecard and then shared the scorecard with their beneficiaries so that they could become informed about the best SNF for their specific needs. This kind of approach translates across markets, and St. Luke’s was happy to share the templates, agreements and the scorecard itself with interested ACO Learning Collaborative participants. 

The Deaconess OneCare Collaborative, another Next Generation ACO partner, developed an approach to implementing the three-day SNF waiver. The waiver is available to all Next Generation ACOs, but it can be complicated to do well. “We had developed what we thought was a solid approach to implementing the three-day SNF waiver, but we had heard from other members of the Collaborative that they were having a tough time,” said Fred Wallisch, MD, Evolent’s Market Medical Director for the Deaconess OneCare Collaborative. “When I heard that one of the other members of the Collaborative was having a real problem implementing it, I said ‘Call me, I can help you with this’ and we’ve been talking about once a month since then just to make sure everything stays on track.”

Another ACO Learning Collaborative member developed a financial model that demonstrated a positive return for payment for Activities of Daily Living, such as transportation, even though it is not directly reimbursable by CMS. They shared this model with the Collaborative at a recent in-person meeting in Chicago, prompting one member to comment “[this discussion] alone was worth the flight to Chicago”. 

Through collaboration between Evolent and the 12 ACOs Evolent supports, the ACO Learning Collaborative focuses on common challenges ACOs face, as well as specific factors that drive performance. Participation in the ACO Learning Collaborative is open to all ACOs for which Evolent provides operational and strategic support. Other ACOs can join the ACO Learning Collaborative as part of certain strategic consulting engagements offered by Evolent. For more information, please contact Bruce Cattie (bcattie@evolenthealth.com).


Disclaimers:

ACO Release of Information

1. The ACO, its Next Generation Participants, and its Preferred Providers shall obtain prior approval from CMS during the term of this Agreement and for six months thereafter for the publication or release of any press release, external report or statistical/analytical material that materially and substantially references the ACO’s participation in the Model or the ACO’s financial arrangement with CMS. External reports and statistical/analytical material may include, but are not limited to, papers, articles, professional publications, speeches, and testimony.

2. All external reports and statistical/analytical material that are subject to this Section XVI.B must include the following statement on the first page: “The statements contained in this document are solely those of the authors and do not necessarily reflect the views or policies of CMS. The authors assume responsibility for the accuracy and completeness of the information contained in this document.”

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