The Evolution of Medicare: Embracing Patient-Centric Care through the Shared Savings Program

Feb 25
07:33

2024

Adam S. Pellegrini

Adam S. Pellegrini

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The Medicare Shared Savings Program (MSSP) represents a transformative approach to healthcare, emphasizing patient-centric care, improved population health, and cost reduction. This initiative is part of a broader strategy by the Centers for Medicare and Medicaid Services (CMS) to enhance the quality and efficiency of medical care. By fostering the development of Accountable Care Organizations (ACOs), the MSSP aims to streamline healthcare delivery, ensuring that patients receive the right care at the right time while avoiding unnecessary duplication of services and preventing medical errors.

The Triple Aim of Healthcare Improvement

Better Care for Individuals

The MSSP encourages the creation of ACOs that prioritize coordinated,The Evolution of Medicare: Embracing Patient-Centric Care through the Shared Savings Program Articles evidence-based care. This approach not only elevates patient satisfaction but also facilitates early interventions that can lead to improved health outcomes. For instance, the use of health trackers and integration of pharmacy and electronic medical records data can help manage redundant testing and enhance medical decision-making.

Better Health for Populations

ACOs are equipped with tools like Health Program Authoring, which allows for the development and deployment of customized care protocols. These protocols support CMS quality measure reporting and enable providers to adjust care plans based on clinical data, thus driving better health outcomes across patient populations.

Reducing Per-Capita Costs

By providing efficient care and enhancing coordination across care teams, ACOs aim to reduce healthcare costs. The integration of data from various sources plays a crucial role in achieving cost savings without compromising the quality of care.

Engaging Patients in Their Healthcare Journey

Patient engagement is a cornerstone of the MSSP. ACOs utilize platforms like HealthyCircles to connect with patients through various channels, including email and social media. By engaging patients and their families in the care process, ACOs can improve health outcomes and foster a collaborative healthcare environment.

Key Features of HealthyCircles for ACO Success

Organizations leveraging the HealthyCircles Connected Health Platform can effectively participate in the MSSP by utilizing its comprehensive features:

  • Care Solutions Library
  • Consumer Portal
  • Triage Dashboard for Population Health
  • Bi-Directional Data Exchange Hub
  • Patient-Centric Care Teams
  • HealthyCircles Engage

These features align with the goals of the Affordable Care Act and the requirements for shared savings eligibility.

Promoting Evidence-Based Medicine and Patient Engagement

ACOs must adopt clinical guidelines based on the best available evidence and adapt them as new evidence emerges or patient needs evolve. HealthyCircles supports this by enabling organizations to select, customize, and update health and disease management programs in real-time.

Patient engagement involves ensuring that patients and their families are active participants in medical decision-making. HealthyCircles delivers patient response-driven guidance linked to clinical protocols, aligning with educational content that supports shared decision-making.

Reporting Quality and Cost Measures

Successful ACOs must manage risk by undertaking population health management at various levels. HealthyCircles allows organizations to build care teams around each patient, enabling the tracking of outcomes at the care team level. CMS proposes to measure quality of care using nationally recognized measures in key domains, which HealthyCircles' tools support.

Promoting Coordination of Care

ACOs must improve the integration of care across various providers and care settings. HealthyCircles provides the necessary infrastructure to meet CMS requirements, including integrating case managers, supporting telehealth, and enabling data sharing via Health Information Exchanges (HIEs).

Providing Patient-Centered Care

The Affordable Care Act defines patient-centered care as incorporating transparency, individualization, recognition, respect, dignity, and choice in healthcare. HealthyCircles is designed to facilitate this approach by moving beyond provider-centric data exchange to patient-centric care.

The HealthyCircles Connected Health Platform

The HealthyCircles Connected Health Platform equips ACOs with the tools needed to prepare for participation in the MSSP. It empowers patient-centered care through evidence-based decision-making and integrated care management involving physicians, care teams, patients, and their families.

For more information on the HealthyCircles Connected Health Platform, please visit HealthyCircles.

Conclusion

The Medicare Shared Savings Program is a significant step towards a more efficient, patient-centered healthcare system. By leveraging platforms like HealthyCircles, ACOs can meet the program's criteria and deliver high-quality care while reducing costs. As healthcare continues to evolve, the MSSP and ACOs will play a pivotal role in shaping the future of patient care.