As the physicians who owned Commonwealth Physicians (Commonwealth)* entered into their first big value-based reimbursement contract, they wanted to make every effort to tip the scales of success in their favor. They understood and believed in the concepts of value-based care and were excited about the potential for substantial shared savings. However, they were equally anxious about the exact steps needed to successfully transition their multiple specialty sites and primary care offices from traditional fee-for-service to value-based reimbursement.
They knew they needed expert help and investigated a broad array of choices including hiring additional staff, expanding the roles of existing staff, and cobbling together a collection of specialized consultants. They quickly realized these choices were too disjointed and cost-prohibitive in the short and long term. Commonwealth wanted a comprehensive solution that would tie together all aspects of its transition – technology, people and process.
Geneia’s Transformation Services helped Commonwealth simplify the evolution to value-based care by delivering customized and coordinated guidance and education throughout the organization. Leveraging decades of experience in managing risk of large patient populations, Geneia soon uncovered gaps in capabilities that would hinder success within the new value-based payment models.
For example, Commonwealth has a large population of people aged 55 and older who like to winter in sunny Florida. From a discharge and care coordination perspective, this travel pattern presented significant challenges that were leading Commonwealth to experience undesirable quality ratings and high utilization costs.
In the words of one physician, “Before Geneia, we were losing track of patients when they left for the winter. After, not only did we have access to their medical data wherever they were treated, but we also had new workflows that supported coordinated follow-up care whether patients were in our home state or living in Florida.”
This one example illustrates how Commonwealth came to think critically about care delivery, use data to drive decisions, establish workflows to support collaborative care, and improve patient health.
Commonwealth soon realized positive returns within that original value-based contract. Since then, it has established multiple successful value-based contracts with multiple payers.
Download the case study to learn more about how Commonwealth achieved value-based care success.