In an effort to achieve better outcomes for patients, Margaret Mary Health has joined with eight other small hospitals to establish an accountable care organization.
Margaret Mary Health, a critical access hospital in Batesville, Ind., serves a population of 65,000 residents, sees the ACO to better provide patients the most appropriate care and no more than what is necessary, says Tim Putnam, the facility’s CEO and president.
The ACO, formed with the goal of improving wellness and population health management, is getting technical support from Caravan Health, the vendor of an ACO platform that seeks to help the hospitals get high scores for quality care and keep patients in their communities.
The hospitals understand that the transition to value-based care is the future of healthcare, Putnam says. The hospitals received funding for the ACO from the Centers for Medicare and Medicaid Services to offset the costs of new electronic health record systems, information technology processing functions and care coordinators.
“We sent public health interns into the homes of patients where we couldn’t get resolution because they weren’t coming in for treatment,” Putnam adds. “Too often, these patients had poor family support services, behavioral health issues and were not getting needed care, so they often made 911 calls when an acute health issue arose.”
Consequently, Margaret Mary Health, supported by data supplied by CMS, started to invest in behavioral health care and soon found that each dollar spent could offset acute care costs.
Some of the savings came in unexpected ways. One doctor, for example, had the highest pharmaceutical costs—patients were filling more prescriptions than other doctors’ patients were. But while the doctor’s prescription costs were higher, he had healthier patients. “Before we had the CMS data, we really couldn’t tell who had heathier patients,” Putnam explains. “We certainly ask better questions now.”
While critical access hospitals often struggle to get the resources they need and may not believe they can afford to move to accountable care, the concept of population health management actually fits better in small provider communities, according to Putnam. “I know my people, how to influence them and improve my patient base. Population health is tailor-made for these small communities.”
For example, Margaret Mary Health works with local churches to have a nurse offer health screenings after church services, which may turn into a formal consultation with a patient and a doctor, which could avoid what later might become an emergency call for medical care.
“We’re big on prevention; we’d rather see 50 colonoscopies than treat one case of colon cancer,” Putnam concludes. “If we can provide these services, people stay here for local care.”