KentuckyOne Health Partners Thrives in the CMS Medicare Shared Savings Program by Optimizing Care Management Technology




About

KentuckyOne Health Partners, one of Kentucky’s first Medicare ACOs, began participation in the Centers for Medicare & Medicaid Services (CMS) Medicare Shared Savings Program (MSSP) in 2013 with a population of 24,000 Medicare lives. Since then, it has undergone rapid growth, and today operates a clinically integrated network of 2,000 providers managing more than 100,000 lives, including 20,000 employee health plan lives and more than 48,000 commercial lives.

Challenge

To achieve its top priorities of better health, better care, better quality and lower cost for managed lives, KentuckyOne Health Partners needed improved data integrity to enable its fast-growing provider network to migrate successfully to a fee-for-value model.

Solution

KentuckyOne Health Partners turned to Conifer Health Solutions to help guide its care managers in driving positive outcomes for its members. Conifer Health’s Population Health Intelligence platform manages the 100,000 lives by capturing enrollment, claims and clinical data to stratify and identify high-risk populations. KentuckyOne Health Partners’ highly trained care management team relies on Conifer Health’s web-based medical management application to manage the needs of plan members. Its providers turn to the Physician Performance Dashboard for management of quality measures and to the Provider Portal for risk stratification and longitudinal care records. The outcome has been improved quality and patient satisfaction, resulting in more than $27 million in Medicare shared savings over the past three years.1



KentuckyOne Health Partners Enhances Quality and Patient Satisfaction through a Compassionate Care Team Using Technology

In its journey to value-based care, KentuckyOne Health Partners achieves measurable results through highly trained care managers using robust technology and population health management data.



Next Steps

As a top 10 percent MSSP ACO performer in 2015, KentuckyOne Health Partners continues to focus on staying ahead of the curve on CMS’ downside risk programs slated to become mandatory in 2019.2 “We are already moving in that direction which allows us to expand market presence including direct-to-employer outreach and employer-based downside risk arrangements as well,” says Brian Christopher, Vice President of Administration, KentuckyOne Health Partners.

Ultimately, KentuckyOne Health Partners aims to be the leading clinically integrated network providing value-based care in Kentucky. Its leadership is confident it will achieve success in bringing better health, quality care and lower costs to its population, as well as increased shared savings through their compassionate and committed care management team working in conjunction with the right technology infrastructure.


References
1 CMS.gov Shared Savings Program Accountable Care Organizations
2 CMS.gov MACRA Ruling
All logos and trademarks are the sole property of their owners.