Danielle F. Casanova, M.B.A.
(703) 838-0033, ext. 347
22 October 2015
Cornerstone Health Care and New West Physicians Receive 2015 AMGF Acclaim Award
Two Additional Groups Honored for Progress toward Achieving IOM Aims and Becoming High-Performing Health Systems
ALEXANDRIA, VA-The American Medical Group Association (AMGA) today presented the 2015 AMGF Acclaim Award to Cornerstone Health Care, PA, and New West Physicians. The Acclaim Award, granted through AMGA’s philanthropic arm, the American Medical Group Foundation (AMGF), is designed to recognize and celebrate the successes that medical groups and other organized systems of care have achieved in improving the value-the quality and cost of care-of the healthcare services they provide to their communities. Two additional organizations, Ochsner Health System and WESTMED Medical Group, were named Acclaim Award Honorees.
This year, the Acclaim Award was presented to one organization with more than 150 physician full-time employees (FTEs), Cornerstone Healthcare, and one organization with fewer than 150 physician FTEs, New West Physicians. The award was presented at AMGA’s Institute for Quality Leadership, being held October 21-23 at the Gaylord National Resort & Convention Center, National Harbor, Maryland.
Cornerstone Health Care, PA
In 2010, Cornerstone Health Care decided to become a value-driven healthcare delivery system, focused completely on the experience of their patients. They implemented a five-year plan using the goals of the Triple Aim: to improve the quality of care, to improve the patient experience, and to reduce the overall cost of care. The organization transitioned from the traditional fee-for-service model to a patient-centered healthcare delivery system providing expanded access, increased coordination of care, enhanced patient education for prevention and treatment of chronic disease, and sophisticated technological support, closely monitoring the care of patients and working with them on how to properly and more effectively manage their conditions.
- By 2014, all of Cornerstone’s primary care practices were recognized by the National Committee for Quality Assurance (NCQA) as a Level 3 Patient-Centered Medical Home™ (PCMH) under 2011 guidelines. The organization was also recognized by Press Ganey Associates, Inc. as a 2012 Success Story Award® winner for patient satisfaction.
- In July 2012, they were selected to participate in the Medicare Shared Savings Program (MSSP), sponsored by the Centers for Medicare and Medicaid Services (CMS), and now work with CMS to provide Medicare fee-for-service beneficiaries with high-quality service and care, while reducing the growth in expenditures through enhanced care coordination. They are a top performer in the program.
- For more than three years, Cornerstone has partnered with Medicare Advantage (MA) carriers to develop unique shared savings programs and doubled the numbers of MA patients while reducing costs. By 2013 they converted all of their commercial payer contracts to value-based reimbursement arrangements. In January 2015, they entered into full-risk partnerships and are developing comprehensive managed care programs to achieve better outcomes for this Medicare patient population.
- Cornerstone reorganized into multispecialty service lines focused on improving clinical care pathways. They developed smart care teams that integrated new healthcare roles focused on coordinating the care of patients within and outside the system. Patients experience a team approach to their health care that includes the right services by the right providers at the right time and in the right place. Individual care models, specific to chronic diseases (such as diabetes, chronic obstructive pulmonary disease, and congestive heart failure) help patients receive the expert care they need to manage their chronic conditions. They have achieved significant improved outcomes, in clinical outcomes for specific diseases and preventive care and in reduced ED and hospital stays.
- Cornerstone initiated a physician and administrative leadership compact and realigned compensation to reward patient access, patient satisfaction, quality, citizenship, and efficiency in addition to productivity.
New West Medical Group
New West Physicians Medical Group, located in Colorado’s Front Range, is distinguished by their dedication to the primary care model, their purposeful attention to innovation, their agility, and their ability to rapidly adapt to changes in the healthcare delivery system. These traits have allowed the organization to continuously improve patient care and outcomes:
- New West’s “Bench to Bedside” program brings new, high-quality, evidence-based medicine into patient care practices within 6-12 weeks. The program has resulted in improved outcomes in prostate cancer management, Barrett’s Esophagus management, intracranial stenting for TIA/Stroke due to intracranial stenosis, and other areas.
- Their primary care offices employ an advanced primary care model. Using a team-based approach, physicians concentrate on patients with complex illnesses while mid-level providers focus on same-day urgent care needs. The medical assistants on the care team operate at the top of their licenses with training to autonomously provide pre-visit planning, health coaching, immunizations, asthma and COPD screening, diabetic foot exams, gaps in care closure, and fall prevention assessment, among other responsibilities.
- When New West identified a major underserved need for behavioral health care throughout their patient population, they added behavioral health clinicians to their clinical staff in 2008. This program has expanded to include full-time mental health clinicians and psychiatrists.
- Through implementing new technology and new care processes, New West has been able to achieve remarkable clinical outcomes for patients, including: 79.7% of patients in control of their blood pressure; all patients with elevated HbA1c referred to a comprehensive diabetes management program; 83% breast cancer screening rate; avoidance of antibiotics for acuter bronchitis in 91% of patients; 42% reduction in tobacco use in the patient population; and 30-day readmission rates of 6.7% for Medicare and 3.1% for commercial.
- Patient satisfaction is high, with 97% rating the group “excellent” or “good.”
- Data transparency has resulted in the top performers establishing best practices to bring up lower performers, markedly enhancing total group performance.
Although New West Physicians has made tremendous strides in its 21 years of business, they know that continuous dedication to the adoption of innovative systems and practices to provide high-quality, high-efficiency care to patients is the key to future success.
Two additional groups were named as Acclaim Award Honorees:
Ochsner Health System
After Hurricane Katrina devastated much of New Orleans and significantly reduced the city’s number of hospital beds and physicians, Ochsner Health System made a deliberate commitment to ensure the region had access to a high-performing health system by investing to develop a region-wide system of care. The organization underwent a transformation from an exclusively employed group practice with its single associated closed-staff academic medical center to a multi-facility, regional system of care that was open, inclusive, and geographically diverse. The organization now operates under a “Triple Strategy”:
- Destination Center: Being the place where people want to be cared for in their time of need. The Regional Referral Center (RRC) was developed in 2009 to eliminate barriers associated with patient transfers from other hospitals across the region. Since its inception, the RRC has enabled more than 34,000 patients to gain access to Ochsner’s care. Since 2013, the organization has focused on six nationally ranked specialties, or Centers of Excellence, for delivery of high-quality care: Cancer, Neurosciences, Transplant, Cardiovascular, Women’s, and Pediatrics subspecialties. In 2012, Ochnser became the first in Louisiana to provide an eICU program to enhance critical care. The program has been proven to reduce complications, shorten hospital length-of-stay, and save lives. Through the Destination Center strategy, Ochsner has become a nationally recognized healthcare delivery system in quality and patient safety.
- Population Health Center: Creating value by improving quality and total cost of care for defined populations of patients. Ochsner’s project to improve access has seen great success, enabling them to accommodate the patients needing same day appointments more than 96% of the time and increasing same-day appointments by 21%. The organization has hired over 42 primary care physicians and 12 advanced practice providers since January 2014 for increased patient access to preventive care, chronic disease management, and wellness services. They believe that value-based reimbursement will be an important tool in managing the total cost and outcomes of care, and have migrated a significant portion of their business in this direction.
- Solution Center: Being the trusted partner in care for other healthcare delivery systems. The Solution Center was introduced in 2014 based on the goal of decreasing the total cost of care by spreading overhead costs. Ochsner engages with partners to create value and improve care coordination.
WESTMED Medical Group
WESTMED Medical Group is one of the largest, premier multispecialty group practices in the country. With nine locations in lower Westchester County, New York, and Fairfield County, Connecticut, the practice is known for its advanced technology including state-of-the-art diagnostic equipment, electronic medical records, and a one-stop-shopping medical experience for patients. This modern approach results in improved communication and collaboration with all providers involved in each patient’s care. WESTMED’s uniquely designed full-service facilities offer patients the convenience of multispecialty services as well as radiology and clinical laboratory all under the same roof. As an accountable care organization, WESTMED insists on the highest quality of patient-centered care in their practice, with a focus on measured excellence.
- WESTMED embedded full-time case managers in each of its primary care offices and conducted data mining for high-risk patients. Mammography, colorectal cancer screening, and diabetes composite scores are all ranked in the top 10% nationwide.
- To reduce unnecessary hospitalizations and ER visits, they embedded pathways in EMR, including GI bleed upper and lower, DVT, TIA, back pain, cellulitis, pneumonia, diverticulitis, diabetic foot ulcer, renal colic.
- WESTMED hired a palliative care team, educated all providers in the benefits of the palliative medicine program, and developed educational programs, which include training in difficult conversations and symptom management education for COPD, CHF, and renal disease.
- For urgent care, WESTMED tracked and reviewed all ER transfers and used ambulatory pathways to avoid ER transfer when it was unnecessary and could be avoided. This has led to a decrease in variability of hospital transfer rate.
- WESTMED conducts focused outreach based on gaps-in-care reports from third-party payers and uses real-time dashboards to monitor and track all quality metrics/gaps in care. Yearly bonus compensation for physicians is based in part on performance metrics of gap closure/quality of care.
- In their Medicare Shared Savings Program, their total cost of care is 14.6% lower than the national average, and they have seen lower utilization rates when compared to all other MSSP ACOs.
- In November 2014, WESTMED’s average care provider score hit a record high for us of 95.9-in the 97th percentile nationally and 99th percentile regionally. In the period of February through April 2015, the group saw a mean score in overall assessment of patient experience of 94.2.
“The Acclaim Award recognizes the remarkable efforts of these groups in order to share their innovations and best practices with the healthcare industry,” said Donald W. Fisher, Ph.D., AMGA’s president and chief executive officer and AMGF Board secretary. “The groups honored with this award exemplify the best quality health care in the United States, and the efforts of multispecialty medical groups and other organized systems of care to provide the right care at the right time in the most efficient manner. Coordinated, value-based care has been the hallmark of AMGA member groups, and programs like the Acclaim Award help these groups continue their innovative work and communicate their successes to the healthcare community to better serve their patients. It is our hope that medical groups throughout the country will learn about the work of these innovators and be inspired to implement similar programs in their medical groups.”
About the Acclaim Award
AMGA’s prestigious Acclaim Award honors organizations that are meeting the IOM Aims for Improvement and are taking the necessary steps to become a High-Performing Health System™ as defined by the AMGA. The award highlights the continued research and investigation toward finding the finest models of medical management, coordination of care delivery, and a systemic approach to improving the patient experience. The recipients of the award receive a Steuben-designed Crystal, produced specifically for the award, as well as national recognition. Honorees also are recognized and receive crystal awards.
The Acclaim Award’s mission is to honor the nation’s premier healthcare delivery organizations that are high performing and are bring their organization closer to the ideal medical group and health system by:
- Measurably improving the quality and value of care
- Improving patient experience and outcomes
- Continuously learning and innovating
- Improving population health
Applicant criteria, structured around the six IOM Aims for Improvement and AMGA’s High-Performing Health System™ attributes, place a heavy emphasis on leadership involvement. Applicants are asked to measurably demonstrate progress toward achieving the six aims, becoming a High-Performing Health System™, and transforming their organizations to provide health care that is consistent with those attributes. AMGA looks for medical groups that have made and documented system-wide changes to improve medical care for large numbers of the patients they serve, and, through the process, consistently improve organizational performance. Applicants are evaluated in a blinded review process conducted by nationally recognized leaders in healthcare quality.
The American Medical Group Foundation (AMGF) supports AMGA members in their efforts to enhance population health and care through integrated delivery systems. The coordinated healthcare delivery model practiced by member groups is becoming the model of choice for quality, cost-efficient care. As a nonprofit 501(c)(3) organization, AMGF supports critical research, demonstration projects and learning collaboratives that translate into the innovative practices that enable AMGA members to produce continued, positive improvement in patient outcomes and care experiences. These activities enable them to remain on the vanguard of quality health care.
The American Medical Group Association (AMGA) represents some of the nation’s largest, most prestigious medical practices, independent practice associations, accountable care organizations, and integrated healthcare delivery systems. AMGA's mission is to support its members in enhancing population health and care for patients through integrated systems of care. More than 170,000 physicians practice in AMGA member organizations, providing healthcare services for 120 million patients (approximately one in three Americans). Headquartered in Alexandria, Virginia, AMGA is the strategic partner for these organizations, providing a comprehensive package of benefits, including political advocacy, educational and networking programs, publications, benchmarking data services, and financial and operations assistance. www.amga.org