case study


Shared Savings Success: A Model For Teamwork


Advocate Physician Partners

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BACKGROUND

Advocate Physician Partners is a leading Accountable Care Organization that unites over five thousand physicians across the Chicago Metropolitan Area and Central Illinois. They are an integral component of Advocate Health Care, the largest health system in Illinois. Advocate Physician Partners has been praised for its population health management and clinical integration program, earning accolades from national publications including The New York Times.

While Advocate Physician Partners clearly excels with these programs, they are still guided by one simple principle; providing the highest quality care while striving to improve patient safety and outcomes. Their ACO first became involved with Medicare’s Shared Savings Program (MSSP) in 2012 and has been consistently reporting substantial improvements in outcomes and financial savings each year.

THE CHALLENGE



While Advocate Physician Partners enjoyed notable success, they were challenged by new regulatory mandates, data requirements and tight deadlines necessary to meet the demands of the Medicare’s Shared Savings Program. Advocate Physician Partners needed to assess, extract, normalize and interpret raw claims data and build a readily accessible data warehouse that stored information for both reporting and analysis. Finally, they needed to upload the transformed claims and eligibility data into the Advocate Physician Partners Cerner HealtheIntent™ for dissemination to the ACO leadership team and to Centers for Medicare and Medicaid Services (CMS) to satisfy MSSP reporting requirements.

A COLLABORATION



Keena and Advocate Physician Partners began their relationship several years prior to the ACO undertaking. It was then that the Keena team fostered an intimate understanding of Advocate Physician Partners’ financial data and operational systems, earning their trust along the way.

THE SOLUTION



Advocate Physician Partners Information Services team worked closely with Keena to leverage its deep knowledge and understanding of healthcare financial data. They designed a system to successfully evaluate and manage the ACO’s shared savings program results through a financial claims and eligibility database.

The resulting solution
accomplished three goals:

  • DATA IMPORT & WAREHOUSE SETUP
    Created an efficient process for importing and integrating claims eligibility and provider data. Once in the data repository, the team analyzed and compiled the data in preparation for transformation.
  • DATA TRANSFORMATION
    Standardized and normalized Medicare claims files and updated practice records to include the most recent and accurate patient data. During this process, they also developed a valuable utility that created longitudinal eligibility history records that Advocate Physician Partners continues to utilize today.
  • DATA UPLOAD
    Imported normalized data to Advocate Physician Partners Cerner HealtheIntent™ system for reporting purposes. These reports were generated for use by various Advocate Physician Partners department stakeholders, government regulatory agencies, and for MSSP reporting requirements

TESTIMONIAL

What Our
Clients Are
Saying
About Us

We appreciate the work that Keena has put into the MSSP project, this is just one example of the quality work they have partnered with Advocate Physician Partners on. We look forward to more successful partnerships in the future.”

— TERRI GODAR

Director of Information Services, Advocate Health Partners

THE RESULT



In partnership with the Center for Medicare and Medicaid Services (CMS). Advocate Physician Partners saved Medicare, taxpayers and beneficiaries more than $60 million in 2016. Ranking second in savings out of 432 ACOs participating in the Medicare Shared Savings Program (MSSP), Advocate was among the highest in quality results while providing care to the largest group of Medicare beneficiaries.
  • Data automation saved Advocate Physician Partners and its staff hundreds of labor hours due to Keena’s development of effective processes and quality database designs.
  • Enabled effective tracking of both financial trends and member-provider attribution for accurate results reporting.

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