Presentation is loading. Please wait.

Presentation is loading. Please wait.

Value-Based Care in Central Texas

Published byΈλλη Βλαστός Modified over 6 years ago

Similar presentations

Presentation on theme: "Value-Based Care in Central Texas"— Presentation transcript:

1 Value-Based Care in Central Texas
Mark Shen, MD, MBA Sr. Vice President of Network Development, Ascension Texas CEO of Ascension Texas Accountable Care Network Interim Clinical Chair of Pediatrics, Dell Medical School

2 Objectives Describe system-level value-based initiatives in Central Texas Analyze barriers to clinical and data integration Define local successes in value-based care

3 Ascension Texas Accountable Care Network
Commercial Pediatrics Commercial Waco Medicare Shared Savings Program Austin Medicare Shared Savings Program Seton ACO Care 4 Texans Dell Children’s Health Alliance Seton Health Alliance Medicaid?

4 DCHA + SHA Covered Lives

5 Membership Assignment
DCHA + SHA 2018 Contracts Insurer United Index United Nexus ACO Aetna Employer Health Network/ Direct to Employer Smart Health Membership Assignment Attribution Product selection N/A Notable Employers Apple, Texas Mutual, Whole Foods City of Austin, Williamson County AISD, General Motors, City of Austin Whole Foods Seton/ Ascension

6 Ascension Texas ACO Network Composition

7 DCHA + SHA Attributed Lives by Group

8 Gateway to Shared Savings Distribution
Modifiers Cost Trend Risk Scores Employer or Product Outliers removed Gate 1: ACO Medical Spend VS Payer Target Gate 2: ACO Quality Scores VS Negotiated Contractual Measures Shared Savings Gate 3: ACO Performance VS Internal Targets/Citizenship Distribution

9 The Problem with Scorecards

10

11 DCHA/ACO Models: What Does Success Look Like?
Shared Savings $40M over 2.5 years Quality Achieved all payer contract quality targets (largely preventative primary care measures) QUESTIONS What is the future of these models? What are payers moving towards? Where is CMS headed? Is this value-able for you?

Download ppt "Value-Based Care in Central Texas"

Similar presentations

Making Payment Reforms Work for Patients and Families Lee Partridge Senior Health Policy Advisor National Partnership for Women and Families January 28,

Making Payment Reforms Work for Patients and Families Lee Partridge Senior Health Policy Advisor National Partnership for Women and Families January 28,
Primary Care in Minnesota Innovations in Primary Care Jeff Schiff, MD MBA Medical Director Minnesota Department of Human Services 13 December 2010.

Primary Care in Minnesota Innovations in Primary Care Jeff Schiff, MD MBA Medical Director Minnesota Department of Human Services 13 December 2010.
Measuring Progress Toward Accountable Care Aurora Health Care Readiness to Implementation Patrick Falvey, PhD Executive Vice President/ Chief Integration.

Measuring Progress Toward Accountable Care Aurora Health Care Readiness to Implementation Patrick Falvey, PhD Executive Vice President/ Chief Integration.
A Quality Focused, Financially Responsible Approach to Medicaid Reform Jeffrey W. Runge, MD, FACEP NC Medical Society Board of Directors February 11, 2015.

A Quality Focused, Financially Responsible Approach to Medicaid Reform Jeffrey W. Runge, MD, FACEP NC Medical Society Board of Directors February 11, 2015.
The Texas A&M System Employee Benefits Administration June 15, 2011.

The Texas A&M System Employee Benefits Administration June 15, 2011.
National Commercial Payer Trends Linda Davis Consultant.

National Commercial Payer Trends Linda Davis Consultant.
New Opportunities for Payment Reform - Minnesota Ross Owen NASHP Annual State Health Policy Conference October 5, 2011.

New Opportunities for Payment Reform - Minnesota Ross Owen NASHP Annual State Health Policy Conference October 5, 2011.
Accountable Care Organizations and Integrative Health/CPMs Karen Milgate, Health Policy Consultant National Association of Certified Professional Midwives.

Accountable Care Organizations and Integrative Health/CPMs Karen Milgate, Health Policy Consultant National Association of Certified Professional Midwives.
HFMA December 2012. Attacking Rising Costs 23% of the Medicare population has a chronic condition with 5 or more co-morbid conditions that compel them.

HFMA December Attacking Rising Costs 23% of the Medicare population has a chronic condition with 5 or more co-morbid conditions that compel them.
Designing Successful Strategies and Alliances. Clinical Quality – Integrity – Service Excellence – Teamwork – Accountability – Continuous Improvement.

Designing Successful Strategies and Alliances. Clinical Quality – Integrity – Service Excellence – Teamwork – Accountability – Continuous Improvement.
Tracey Moorhead President and CEO May 15, 2015 No Disclosures ©AAHCM.

Tracey Moorhead President and CEO May 15, 2015 No Disclosures ©AAHCM.
CONFIDENTIAL AND PROPRIETARY - 1 Quality Satisfaction Efficiency Bringing You More Than Ever Before LVBCH June 23, 2015.

CONFIDENTIAL AND PROPRIETARY - 1 Quality Satisfaction Efficiency Bringing You More Than Ever Before LVBCH June 23, 2015.
Physician Leader Perspective of ACO Transition Scott D. Hayworth, MD, FACOG President and CEO Mount Kisco Medical Group, PC.

Physician Leader Perspective of ACO Transition Scott D. Hayworth, MD, FACOG President and CEO Mount Kisco Medical Group, PC.
National Stage for IHS Innovation Aligning IHS Strategic Initiatives with Federal Payment Reform Opportunities.

National Stage for IHS Innovation Aligning IHS Strategic Initiatives with Federal Payment Reform Opportunities.
Foundations for a Successful Patient-Centered ACO: Federal Law Background Jim Dearing, D.O., FACOFP, FAAFP Chief Medical Officer, Physician Network John.

Foundations for a Successful Patient-Centered ACO: Federal Law Background Jim Dearing, D.O., FACOFP, FAAFP Chief Medical Officer, Physician Network John.
An Overview of Potential 1115 Waiver Program Options for California Children’s Services Sally Bachman, Ph.D. 617-353-1415

An Overview of Potential 1115 Waiver Program Options for California Children’s Services Sally Bachman, Ph.D
Maine Association of Area Agencies on Aging: Aging Advocacy Summit November 14, 2012 Bill Wypyski, LCSW, MPA, MS Chief Executive Officer Harrington Family.

Maine Association of Area Agencies on Aging: Aging Advocacy Summit November 14, 2012 Bill Wypyski, LCSW, MPA, MS Chief Executive Officer Harrington Family.
Excess cost growth in Medicare, Medicaid, and all other health care spending Source: CBO, A Federal Perspective on Health Care Policy and Costs, 2008.

Excess cost growth in Medicare, Medicaid, and all other health care spending Source: CBO, A Federal Perspective on Health Care Policy and Costs, 2008.
Hays County Healthcare District and Access to Healthcare for the Underprivileged.

Hays County Healthcare District and Access to Healthcare for the Underprivileged.
September 10, 2014 Research Healthcare Environment.

September 10, 2014 Research Healthcare Environment.

Similar presentations

Ads by Google