Helping patients avoid unnecessary trips to the hospital and promoting better overall health while lowering the overall cost of care are just a few of the reasons Mount Desert Island Hospital is participating in Eastern Maine Health System’s pioneer Accountable Care Organization (ACO).
The ACO is a component of the Patient Protection and Affordable Care Act (ACA) that places greater emphasis on preventive care and improved communication between everyone involved in caring for patients. Under the definition of the ACO, this program is exclusively for patients who are covered by Medicare and are a primary care patient of one of MDI Hospital’s providers.
The invitation to join the ACO was extended to MDI Hospital in large part because of the organization’s previous success developing the patient-centered model and experience with improved chronic illness management.
MDI Hospital is currently expanding its participation in a statewide Patient Center Medical Home pilot to many of its primary care practices, building on the successful program at Southwest Harbor’s Community Health Center. The patient centered medical home refers to an ongoing, active partnership with a primary care provider who leads a team of professionals dedicated to providing proactive, preventive and chronic care management through all stages of life.
This past May, MDI Hospital was awarded a $450,000 federal grant to lead a group of local agencies in the development and implementation of a patient-based program to identify those who may be at risk for diabetes and provide evidence-based methods on finding ways to improve their health.
“Our providers see the value, not just in terms of health care dollars, but in improved health among our patients who participate in these programs,” said Arthur J. Blank, MDI Hospital’s president/CEO. “The ACO relationship will enable our providers to expand the team approach to more patients for better health at a lower cost.”
Depending on an individual’s general health, the team approach of the ACO model may offer greater support and encouragement to stay healthy. Patients with more involved medical needs may receive regular calls from a nurse just to check in. Care will be better coordinated to avoid duplication of testing, complicated treatments or trips to the emergency room. Providers will also have improved access to pertinent health information and will be able to share it with all of those involved in care.
Traditionally, health care providers were paid for units of health care services and procedures delivered, but through this new model, providers will be reimbursed for the quality of care provided, for clearly improving outcomes for our patients, and for reducing overall cost of health care.