Identify potential VBCOs whose beneficiaries may be receiving care in your GED.
- Contact representatives from your hospital or health system’s Population Health,
Utilization Review, Executive Suite, and/or Contracting teams to inquire about at-risk
beneficiaries receiving care in your GED. - Research potential VBCOs within your community in order to locate potential
collaborators.- Physician Group collaborators could include:
- A list of the Top 25 Physician Groups by size can be found here.
- Accountable Care Organization (ACO) collaborators could include:
- A list of the Top 25 ACOs by patient population can be found here.
- A list of MSSP ACO beneficiaries with a patient visit to a GED can be found here.
- Medicare Advantage (MA) Plan Providers could include:
- A list of the Top Medicare Advantage Plan providers by state can be found here.
- Some Top MA Provider Groups include:
- Physician Group collaborators could include:
MA Provider Group | Key Regions |
AARP/UnitedHealthcare | National Presence |
CenterWell by Humana | FL, GA, NV, TX |
ChenMed | FL, KY, MI, OH, TX, VA, Philadelphia |
Conviva by Humana | FL, TX |
Landmark Health | CA, NC, NY, PA, Dallas |
Iora Health | CA, NC, NY, PA, Dallas |
Oak Street Health | IL, IN, OH, Dallas, Detroit |
Optum | National Presence |
Wellmed | FL, TX |
Collaborate with representatives from your hospital or healthcare system to contact local VBCOs in order to develop collaborative partnerships.
The first steps you will need to take to develop a successful partnership are:
- Identifying VBC beneficiaries in the ED. It is important to inventory how your GED and
Value-Based care partner currently share beneficiary information. A recognized pain
point is that VBC organizations are not aware in real time when a beneficiary is in the
ED. Similarly, ED teams do not know when they are treating a patient in a risk-based
arrangement with access to extra resources. - Enable and Incentivize Real-Time Communication. Collaborative communication
protocols, such as an alert mechanism, expedited phone/text messaging, or integrated
features within a hospital’s electronic health record, are key to creating patient safety
and durable dispositions.
Launch ongoing quality improvement projects with your VBCO partner around shared metrics.
Some ideas for collaborative projects with your local VBCO could include:
- Creating a Care Management connection for rapid access to outpatient medical and home-based services
- Primary Care and Specialty Follow-Up
- Medication Management
- Physical Therapy Consultations