Lahey Health

Fall 2015 Whats Next in Health Care_FINAL

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I N N O V AT I O N • C O L L A B O R AT I O N • E X C E L L E N C E F A L L Continued on page 5 MEET "RAYMOND." While his name has been changed to protect his privacy, Raymond is a real patient — one who has complex medical needs and has benefited from the Winchester Community Accountable Care Organization (WinACO). The ACO model links WinACO Care Management Specialist Judy Dyer, RN, MSN, MA, assesses a patient's needs. Engaging Patients One at a Time Lahey Health ACOs Are Top Performers reimbursement to quality and patient satisfaction. In one year, Raymond was admitted to the hospital seven times and had three emergency visits and more than 60 physician visits. Then Raymond met his new nurse care manager, Kathy, who worked with him to better understand his needs and coordinate resources so he could go home and stay well. With the added support, Raymond visited the Emergency Department and hospital each only once in 2014 and had only four scheduled visits to his physician's office. The cost of his care dropped $70,000 in one year. "Kathy was able to engage Raymond and empower him to be part of the decisions that would make his life better," said Catharine Robertson, Executive Director of Physician Services at Winchester Hospital. Stories like Raymond's demonstrate the success of Lahey Health's ACOs — the WinACO and the Lahey Clinical Performance ACO (LCP-ACO) — which in 2014 generated shared savings of $10.9 million and $11.7 million, respectively. The WinACO led all Massachusetts ACOs in savings per beneficiary and finished first nationally with the highest percentage of savings over and above the target set by the Centers for Medicare & Medicaid Services (CMS). (For each ACO, CMS sets an individualized cost reduction goal based on the organization's prior expenditures.) The LCP-ACO ranked second in Massachusetts in 2014 for both total and earned shared savings. "These results reflect Lahey Health's commitment to delivering high-quality care at an affordable cost, and demonstrate the success of our collaborative Changing Health Care WATCH HOWARD GRANT, JD, MD, President and CEO of Lahey Health, discuss the importance of correcting dysfunction in the health care marketplace in a new video filmed in the style of a TED talk, a short presentation of an idea in less than 20 minutes. "Health care costs in Massachusetts are outrageously high and, frankly, unsustainable," Grant said in the video. "We can do something about it. We can solve this problem." Grant attributed the market's current state to widely disparate provider prices that are not linked to quality. The state's health care system is designed to essentially subsidize patients who seek treatment in higher- cost settings, leading to higher costs for all, he said. Lahey Health's mission is to deliver high-quality care in the most appropriate, cost-effective setting. Visit LaheyHealth.org/Forward-Thinking to see the video. n Story on page 5 New Ad Campaign

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