Geisinger Health System rheumatologists have created a new care model for rheumatoid arthritis patients that has produced significant improvement in quality of care and reduced cost through 22 months of follow-up.
Attribution, Integration, Measurement, Finances, and Reporting of Therapies (AIM FARTHER) is the new value-based, population-care model designed and tested on 2,378 RA patients cared for by 17 Geisinger rheumatologists. The rheumatologists launched AIM FARTHER in August 2012 and reported that cost savings tallied from de-escalating use of costly biologic drugs came to $720,000 for 2013. They project a savings estimate of $1.2 million for 2014.
The AIM FARTHER care model includes seven components: registry development; defining roles and attribution; integration of primary and specialty care; a new strategic approach to RA care; RA quality measure bundle development; task management and performance reporting; and a new financial incentive model.
Using a specialized Geisinger-developed software system called PACER that collects information from patients via a touchscreen questionnaire, physicians, nurses, and the electronic health record, GHS rheumatologists created a patient level scorecard to measure RA patient care gaps. The individual patient scorecard results were then rolled up into performance reports at the provider, department and division level, and shared to improve overall patient care and cost savings.
The studys authors reported that 40 percent of the patients had achieved 100 percent of their applicable quality measures at 22 months, compared to only 22 percent at the beginning of the study. Additionally, the percent of patients with low disease activity or remission improved from 35 percent to 53 percent. They also noted significant improvement in all but one of the nine quality measures tracked.
We recognized the importance of objectively and routinely measuring disease activity, and using that information to engage our patients and drive a new systematic strategic approach to rheumatoid arthritis care, said Eric Newman, M.D., director of rheumatology for Geisinger Health System and AIM FARTHER program designer. By using people, process, and information technology in new and novel ways, we hoped to be able to improve the lives of those that we serve our patients.
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