How Coordinated Care Organizations (CCOs) are Reducing ER Frequent Flyers in Oregon
Care Coordnation efforts result in fewer hospital admissions, lower overall costs, and healthier patients in OR and other programs across the country
Kaiser Health News reports that Oregon's new Coordinated Care Organizations are already making an impact on ER visits and lowering total costs for the state's costliest patients, also know as "Frequent Flyers" who visit ERs frequently and result in a large share of admissions. While still very early in the program, the program will run for five years and attempt to prove that providing more proactive help to patients will improve their health while simultaneously reducing the number of ER visits and lowering overall costs.
Coordinated Care Organizations are authorized in the State of Oregon to focus on the state's Medicaid patients in an effort to get them the care they need, help coordinate services among numerous providers, and help patients transition among care settings. Care Coordination otherwise falls to the patient or a family member, as traditional fee for service models have never accounted for the need to have a Coordinator. The results of ignoring the need to coordinate care are abysmal, and even modest efforts to help coordinate services for patients have shown meaningful improvements in both cost and quality.
The $2 billion project in Oregon, which utilizes a network of Coordinated Care Organizations (CCOs) that the state authorizes, is expected to result in savings of more than $2 billion in the first five years. Once established, programs like this should be self funding and fully sustainable as they expand.
Gov. John Kitzhaber, a Democrat and a former emergency room doctor, makes the case that should Oregon's model ultimately prove successful and were it to be adopted by the other 49 states, the net savings to the system would be in excess of $1.5 TRILLION over 10 years. To put this in perspective, Congress is looking to find ways to cut Medicare spending by a mere $1.2 trillion. Hmmm. Perhaps the way to reduce health care spending by the goverment is to actually develop models like this that are both more effective and more efficient? Most health care experts agree on this but are divided on exactly how to do it. Models like Oregon's CCOs, federally funnded Care Transitions Initiatives (CTIs), and Accountable Care models are essentially aimed at solving the same problems of cost and quality. Even local programs to simmply reduce hospital readmissions essentially aim to solve some of the same problems. Organizations like the National Transitions of Care Coalition (NTOCC) dedicate their work to investigating ways to better manage Care Transitions to achieve better results and reduce overall costs of care.
Of course, there are challenges. Does Oregon's early success guarantee ultimate success? Can these first models such as Oregon's CCOs support large scale? Will ACOs succeed? Can populatons of patients be analyzed properly to identify those at greatest risk? Can care delivery be managed efficiently on a large scale? Technology must be leveraged to identify patients, enable and measure these models, keep costs low, and assure scalability to support larger patient populations. Post acute providers will also be a big part of these answers and must also automate to improve efficiencies and scale now.
Current technologies are often an obstacle to these programs. Traditional Electronic Medical Records (EMRs) such as those from companies like EPIC, McKesson and Cerner are limited to large hospital systems and were built to support an old fee for service paradigm. They were never intended to coordinate multiple providers or different types of services as patients transition among care settings. For that, a new health care specific "work management" platform such as Ankota's is needed. Fortunately, other industries have pioneered these models and developed highly efficient operating models that health care providers can learn from. Wiith reliable and secure mobile and internet technologies already available, it won't be long before these platforms become commonplace in health care, too.
We at Ankota believe that models like this are only beginning to scratch the surface of what is possible through better care coordination and improved operating efficiencies. That's why we've solved Care Coordination requirements through our Helathcare Delivery Management platform, which connects providers and helps them both coordinate care and operate efficiently. To learn how Ankota's Care Coordination technology enables models like this, click the really cool blue button below and we'll send you some information.