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Care Coordination, Actionable Analytics Help Pioneer ACO Achieve Success

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Speaker 1: Monarch is transferring healthcare one patient and physician at a time.

Dr. Michael Weiss: Monarch's approach to care is what we call physician-centric. The way that we're transforming healthcare is that day-to-day interaction between patient and physician.

Anita Allen: Monarch is transforming healthcare by helping our Medicare beneficiaries navigate through the Medicare system one day at a time.

Speaker 1: When we were forming Monarch 20 years ago, we made a commitment to add accountability to the delivery of healthcare.

Jay Cohen: With Independent Practice Association, we contracted with over 2,200 physicians, primary care and specialist. 19 hospitals we have direct relationships with and take care of about 200,000 beneficiaries.

Speaker 1: Monarch was an accountable care organization long before that term was ever coined.

Bart Asner: Monarch's always recognized that the cost trended healthcare was actually unsustainable and we felt responsible for helping to resolve that problem.

Dr. Nernine Morcos: With the whole change in healthcare, Monarch was our guiding light and they were our information source. They're on the forefront of healthcare and healthcare reform.

Colin LeClair: In this Orange County, only 47% of the population is in a managed care product. We looked at the other 53% and said, "There seems to be a huge opportunity to improve care and outcomes for this other population."

Bart Asner: We saw an opportunity to help solve some of the problems nationwide by lowering the cost of care.

Colin LeClair: The objective of the Pioneer ACO program is to provide Medicare fee-for-service beneficiaries with better care coordination, providing their physicians with better data to help with that care coordination, and ultimately to keep them out of the hospital and stable and healthy at home.

Dr. Michael Weiss: Monarch's Pioneer ACO program is really about care coordination and that's what I like the most. Our system today is so fragmented that what we really need is to connect the dots. What Monarch's ACO program does is connect the dots. It's about taking patients from the inpatient setting to the outpatient setting, to the ancillary setting, and assuring that that communication occurs across that entire continuum of care.

Colin LeClair: We attribute a huge amount of our success to just starting off on the right foot by hiring or contracting with the best of our best physicians.

Dr. Robert Feldman: As a physician, the ACO has brought me a chance to go ahead and get information about my traditional Medicare patients. I didn't know who they were seeing, what they were receiving in terms of medications, whether they had received the vaccine in the hospital or from another provider. It really made it difficult to accomplish what I needed to accomplish. The ACO has given me tools that enable me to manage my Medicare population efficiently and effectively and I think better.

Jay Cohen: Monarch had been involved in coordinating care for patients for many years already. We had some of our own capabilities in place, but Optum had much more sophisticated technology solutions that we were able to tap into to help us with our patient population analysis and stratification and screening.

Bart Asner: Actually of the 32 Pioneer ACOs, we were number two in the country. We saved the Medicare program 6.3% of expected cost over the first year and that is phenomenal.

Dr. Michael Weiss: Quite frankly, it's all about analytics.

Richard Kikuchi: It's important to have IT involved from the beginning because it's hard to make good decisions without good data.

Bart Asner: Its absolutely crucial to have the right technology tools to be successful in an effort like the Pioneer ACO.

Jay Cohen: Optum's analytics proved to be very, very helpful for our doctors.

Speaker 1: In terms of what analytics can do for me as a physician is enables me to find out which of my patients have not received what they need in terms of chronic care management. Just the information that you receive enables you to take care of your patients better.

Bart Asner: Monarch has always been recognized as an innovator in healthcare with fairly sophisticated technology tools, but our affiliation with Optum has taken those tools and capabilities to a much higher level, allowing us to outstanding results in the Pioneer ACO.

Jay Cohen: What I'd like to tell other healthcare organizations about the ACO program is that bearing risk is not for the faint of heart.

Dr. Nernine Morcos: I believe the future of healthcare is exactly what we're going through right now with the Pioneer ACO and shared savings.

Speaker 1: If you embrace it, it gives you more power and it gives you the ability to take better care of your patients. Your patients can get more.

Colin LeClair: The fee-for-service paradigm is shifting rapidly and Optum solutions are helping us to navigate the journey from providing care to managing health.

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Monarch HealthCare, an independent practice association (IPA) and one of the lead Pioneer ACOs, was known for providing quality care and controlling its costs. Even so, achieving shared savings under a value-based model of care wasn’t a foregone conclusion. By focusing its efforts on key strategies that included care coordination and actionable analytics, Monarch successfully bent the cost curve and achieved the second-highest percentage shared savings among Pioneer ACOs.