eBrightHealth ACO

A PARTNERSHIP FOR SUCCESS

About the eBrightHealth Accountable Care Organization (ACO):

In an innovative statewide partnership, the eBrightHealth ACO Shared Savings Program brings together physicians, four of Delaware’s leading health systems – Bayhealth Medical Center, Beebe Healthcare, Christiana Care Health System and Nanticoke Health Services – and Westside Family Healthcare, a federally qualified health center. 152 primary care physicians and other healthcare providers form the base of the ACO team that will set out on a new way of delivering care aimed to lower growth in healthcare costs while putting Medicare beneficiaries first.

eBrightHealth ACO partners with physician colleagues to develop a clinically integrated network. Clinical integration brings together physicians, the hospital and other healthcare providers to develop and sustain clinical initiatives that improve access to care, clinical quality, cost control and the patient experience by:

  • Coordinating the continuum of care across affiliated caregivers, including employed, contracted and partnered community physicians
  • Implementing evidence-based clinical protocols to enhance patient outcomes
  • Establishing a meaningful set of quality measures to review clinical care and improve clinical performance
  • Achieving efficiencies in the delivery of care
  • Partnering with payors to develop contracts that drive definable clinical improvement and add value to patients.

eBrightHealth ACO at Nanticoke

Nanticoke is participating in eBrightHealth ACO, an  Accountable Care Organization (ACO).

What’s an ACO?
  • Are groups of doctors, hospitals, and/or other health care providers that work together to improve the quality and experience of care you receive. Our practice chose to be part of an ACO because we think it will help us provide better care for our patients.
  • Don’t limit your choice of health care providers. Your Medicare http://www.nanticoke.org/wp-content/uploads/2019/08/Graphic_Important-e1565974616640.jpgbenefits aren’t changing. You’ll have the right to visit any doctor, hospital, or other provider that accepts Medicare at any time, just like you do now.
  • Are evaluated by Medicare to see how well each ACO meets these goals every year. Those ACOs that do a good job can earn a financial bonus. ACOs that earn a bonus may use the payment to invest more in your care or share part of it with your providers. Sometimes, ACOs may owe a penalty if their care increases costs.
  • Aren’t a Medicare Advantage plan, an “all in one” alternative to http://www.nanticoke.org/wp-content/uploads/2019/08/Graphic_Important-e1565974616640.jpgOriginal Medicare, offered by Medicare-approved private companies. An ACO isn’t an HMO plan, or an insurance plan of any kind.
What does this mean for my care?
  • Giving health care providers the option of working with a group like eBrightHealth ACO is one of the ways Medicare helps us better coordinate your care and give you better quality care.
  • To help us coordinate your health care better, Medicare shares information about your care with your providers; like dates and times you visited a health care provider, your medical conditions, and a list of past and current prescriptions.
  • Sharing your data helps make sure all the providers involved in your care have access to your health information when and where they need it. This information helps eBrightHealth ACO give you better, more coordinated care by keeping track of the care and tests that you’ve already had. It may also make it easier to spot potential problems before they’re more serious – like drug interactions that can happen if one doctor isn’t aware of what another has prescribed.
How can I make the most of getting care from an ACO?
  • Ask your clinician about signing up for our secure online portal that gives you 24-hour access to your personal health information, including lab results and provider recommendations. This will help you make informed decisions about your health care, track your treatment, and monitor your health outcomes.
  • Let Medicare know who you consider your primary clinician or “main doctor.” Your primary clinician is the health care provider you believe is responsible for coordinating your overall care. If you choose a primary clinician, that clinician may have more tools or services to help with your care. We can tell you more about how to do this.
  • Continue to let Medicare share your health care information to help us better coordinate and improve the quality of your care. If you don’t want Medicare to share your health care information, call 1-800-MEDICARE (1-800-633-4227). Tell them that your health care provider is part of an ACO and you don’t want Medicare to share your health care information. TTY users can call 1-877-486-2048.
Questions?
  • For more details about our ACO, ask the front desk for a copy of the ACO beneficiary notice.
  • If you have questions or concerns, call us at 302-536-5272, or we can talk about them during your visit in our office. You can also call 1-800-MEDICARE or visit Medicare.gov/acos.html.

Better care, better health, better cost

Consistent with national trends, the eBrightHealth ACO intends to structure reimbursement models to incorporate performance and value-based pay methods to focus on achieving quality, efficiency and cost-management measures.

Many observers describe the current healthcare environment as a “magic moment in time” due to the opportunity it presents to transform the healthcare delivery landscape. Nanticoke Health Services believes there is no better moment to partner on a new model of care that aligns with the Triple Aim championed by the Institute for Healthcare Improvement:

  • Produce better care for individuals
  • Produce better health for populations
  • Lower per capita healthcare costs

Benefits of a clinically-integrated network:

Patients
  • Improved safety
  • Improved quality of healthcare
  • Better access to the latest proven techniques and treatments
  • Streamlined interactions with healthcare system—less waiting and duplication
  • Fully informed physicians and medical staff
Physicians

  • Access to complete patient information
  • Ability to deliver higher quality care
  • Ability to monitor patient compliance
  • Ability to sell combined services of network to payors, making independent practice more viable, especially for small practices
Hospitals
  • Higher degree of effective collaboration
  • Improved clinical quality and patient safety
  • Base of independent physicians aligned with hospital
  • Ability to manage costs
  • Differentiation in the market as high quality provider
Insurers
  • Higher subscriber satisfaction
  • Cost efficiencies and savings
  • Higher quality healthcare for subscribers
  • Easy access to objective utilization data
Employers

  • Containment of healthcare costs
  • Healthier employees Community
  • Ability to maintain independent physician practices
  • Better healthcare
  • Ability to recruit medical talent to area
  • Reduced costs