|Dear Cooper Practitioners,
As many of you know, Cooper has now launched our Accountable Care Organization (ACO) known as AllCare Health Alliance. For those of you who are unfamiliar with an ACO, please click here to link to an educational post about what is an ACO and how it is important to our strategy at Cooper. For the first year of the program, the ACO will encompass our primary care physicians in internal and family medicine as well as our hospitalists.
For your information, we also submit to you the following email communication, which we sent to our ACO participant physicians.
Dear Primary Care Practitioner:
We are embarking on exciting times here at Cooper with the start of the AllCare Health Alliance Accountable Care Organization (ACO) and we are seeing what will be the beginning of value-based reimbursement in favor of the historical model of fee-for-service. Our primary care physicians need to be ready for the changes that will essentially accompany that switch. Some of the changes you will see include:
There is a focus on quality performance. We have been using the diabetes composite as a paradigm for primary care quality as all of you have seen in this monthly report by now. We have tried to be completely transparent about these results and will continue in that effort. Diabetes management is integral to what we do, and we in primary care are experts in this field. We need to get this right to prove that we can get other processes right in the areas of chronic disease management.
· A new organizational structure has arisen with the ACO. Many of you have been asked or will be asked to participate in the ACO governance structure. This is an excellent way to affect change for the organization and to bring our collective minds together to deliver the best product around.
· Practitioner decision support is essential to strong performance. Through EPIC we are able to use best practices that are employed throughout the country to facilitate the care being delivered directly to our patients. All best practice alerts (BPAs) are evidence based and are only deployed in areas where strong impact is warranted.
· Infrastructure enhancements are taking place around you.
o We are working to standardize patient access through the exhaustive efforts of the Access Center.
o Now that the EPIC transition has taken place, we are able to move forward into new capabilities for our electronic health record.
o Advanced Practice Providers are playing a larger role in primary care.
o Voice recognition software is being installed for practitioners.
o Mechanisms to facilitate the EPIC in-basket work for refills, MyCooper communications, and other requests are being created to off-load the practitioner from some of the burdens that accompany a busy practice.
· Care Coordination is a big part of the new primary care model. Care coordinators are used to outreach to patients who may be struggling with the management of chronic illness or may be impacted by emotional, social, or access problems that limit their ability to care for themselves. Care coordination is deployed to those who have the highest level of need in the system. Care coordinators will be assisted in many cases by health coaches who are trained at following up on practitioner orders to ensure adherence for solid health care delivery. As our practices gain status as Patient Centered Medical Home (PCMH) practices, care coordination is an essential part of the mix along with additional supportive patient offerings which will be described in detail in a future communication.
· Documentation of disease severity is essential. Medicare uses a system called the Hierarchical Condition Codes (HCCs) to collect information about disease severity in an individual. HCCs reset each year, so documentation of a chronic condition in a given calendar year is crucial to demonstrate the depth of care being delivered by our practitioners. We are developing an HCC education program and incorporating an EPIC HCC module to facilitate our practitioners’ documentation.
· A new Medicare physician reimbursement structure is coming. Through MACRA legislation in 2015, and the unknown to come in 2017, industry leaders from the American College of Physicians, American Academy of Family Medicine, American Medical Association, and others believe that change is warranted and WILL happen. Our ACO and MACRA preparedness team are working to have Cooper’s strategy agile and ready to handle the challenges of the new landscape. The reimbursement structure for primary care at Cooper will eventually likely incorporate those elements that are essential to the restructured Medicare payment system.
· Communication is essential. As you might expect, any journey on which we embark will likely need navigational corrections somewhere along the way. Please be aware that while it is impossible to predict all permutations of how the new system will work, your leadership team will be most satisfied if all of our practitioners thrive in this new environment. We want to hear your questions and concerns as well as your suggestions to create a Cooper primary care that serves at the model for others to emulate.
At Cooper, our goal is to use the right people, processes, and technology to create a path for our practitioners to flourish. We remain dedicated to the “quadruple aim” as described in the primary care literature: exceptional health outcomes, improved patient experience of care, high value in the care delivered, and improved caregiver experience of care.
We welcome your input here and look forward to working with you.