Hospital joins national accountable care partnership

GREENFIELD — Hancock Regional Hospital is working to keep its most vulnerable senior citizen patients healthy.

The hospital and Hancock Physician Network recently joined an accountable care organization called the National Rural Accountable Care Consortium, along with four other suburban Indianapolis hospitals.

The partnership is a win-win for the hospital and its patients, officials said. Qualifying patients will be matched with medical professionals who help them manage their illnesses and develop long-term health care plans, and the hospital will receive increased Medicare reimbursements based on its performance in the program.

In order for the hospital to participate in some Medicare reimbursement plans, it has to be a member of an accountable care organization, said Rob Matt, vice president of business development.

The goal of accountable care organizations is to help patients who are already healthy maintain their health and to help those who are chronically ill become better.

“That’s the heart and soul of what this is about,” Matt said.

He said there’s a pyramid that represents all of the hospital’s patients.

The base of the pyramid is for healthy patients who don’t need constant health care, and the middle of the pyramid is for patients who aren’t sick but might visit doctors more frequently because of their age.

The top of the pyramid represents patients who are chronically ill. Often, that tier represents senior citizens.

The accountable care organization works to identify patients and prevent the bottom of the pyramid from moving to the top by keeping them healthy.

It helps the top third be as healthy as possible.

“That’s the work this ACO as a collective will start to work on,” Matt said. “If we do a good job at that, if we prevent patients from moving to the top third, … we get better reimbursements from Medicare.”

Currently, the hospital and physicians are contacting its most vulnerable Medicare Part B patients to let them know they’re able to take part in the program.

Patients who choose to participate will work with a care coordinator at Hancock Physician Network to coordinate care for their long-term health and help them navigate the health care system.

The care coordinator will work with those patients to educate them about managing their diseases by learning about their medical backgrounds and what barriers are getting in the way of their health, said Louisa Hayenga, director of operations for Hancock Physician Network.

“It’s all about access to health care,” Hayenga said. “We want to help them make good choices using the emergency room. We want to help them make good choices in how they take medication. We want them to visit a physician.”

The health care system is adapting to focus more on keeping people healthy to prevent them from being hospitalized, and the creation of accountable care organizations are part of that effort, Matt said.

“We need to be available for them when they’re sick. We have to work just as hard, if not harder, at keeping you healthy,” he said. “So when you do visit the doctor, it’s not just, ‘Hey, are you sick,’ it’s ‘Hey, are you getting good exercise?’”

Visits with the care coordinator will cost Medicare Part B patients about $8, Hayenga said.

Patients will hear from their primary care provider or receive a letter in the mail to schedule a free annual wellness visit.

Hospital CEO Steve Long is excited the hospital will be working with care coordinators to assist senior citizens in staying healthy, securing care when needed and avoiding repetitive tests.

“We are very excited to work with our medical community to assist our most vulnerable senior citizens seek care when they need it as well as maintain them in their homes whenever possible,” he said in a news release.

About the partnership

Hancock Regional Hospital and Hancock Physician Network have joined an accountable care organization called the National Rural Accountable Care Consortium.

The accountable care organization works to keep patients healthy and manage their treatment plans if they are ill. The hospital has hired a care coordinator to work with senior citizens who receive Medicare. The care coordinator will work to assist senior citizens to stay healthy, secure care when needed and avoid repetitive tests.

Medicare patients will hear from their primary care provider or receive a notice in the mail to set up a free annual wellness visit.

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Samm Quinn is a reporter at the Greenfield Daily Reporter. She can be reached at 317-477-3275 or squinn@greenfieldreporter.com.