HGB named a top ACO provider in the nation based on quality measurements

Hayes Green Beach Memorial Hospital has been ranked as second of 260 hospitals across the nation for quality outcomes, patient satisfaction, cost containment and provider engagement as a member of Caravan Health’s Accountable Care Organizations (ACOs). HGB participates in the Southern Michigan ACO, which was recently named Caravan Health’s ACO of the Year.

ACOs are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high-quality care to Medicare patients. The goal is to ensure patients get the right care at the right time, while avoiding unnecessary duplication of services, and focusing on overall wellness and prevention.

Quality performance for hospitals within the ACO is evaluated by 16 metrics, such as ensuring patient screenings are up-to-date, measuring body mass index, performing fall-risk assessments and more, all to gauge the best way to proactively support a patient’s health care before he or she has an event or episode that requires emergency or urgent care.

“Our success is absolutely due to physician engagement and our Clinical Integration Team,” said Patrick Sustrich, HGB chief integration officer.

HGB’s Clinical Integration Team focuses on population health efforts and chronic care management. It includes four full-time registered nurses and medical assistants, a full-time social worker and a part-time paramedic. In 2018 the team expanded its efforts from 1,700 traditional Medicare patients to 8,500 patients that also include those insured by Blue Cross Blue Shield of Michigan and Blue Care Network.

“We have taken what we have learned with our Medicare patients, and applied those opportunities to BCBSM and BCN patients,” Sustrich said. “HGB is actively part of an effort that is fundamentally changing the way health care is being delivered. We are identifying individuals with chronic illness or multiple chronic conditions, and rather than reacting to their symptoms when they arrive at the hospital, we are proactively managing their health care to help them avoid hospital visits.”

One example is an ongoing patient success story about an individual who was identified by the Clinical Integration Team. They noticed a trend of five emergency room visits in a three-month period.  The patient was having repeated episodes of heart palpitations, where they could feel their heart beating rapidly and irregularly. The symptoms were significant enough that the emergency department staff encouraged the patient each time to follow up with their primary care provider. When the Clinical Integration Team reached out, the patient hadn’t yet scheduled that follow-up care. They proceeded to help the patient get an appointment with their physician, get on the right medication, ensured they were taking the medicine properly, and now regularly follow up to see how the patient is progressing. There have not been any return visits to the emergency department in six months, and the patient’s health is being properly managed.

“These are the kinds of positive outcomes happening within ACOs as we help patients understand how to be proactive and manage their health,” Sustrich said. “We are proud to be part of a group of hospitals that is routinely seeing these kinds of successes, and was named as the best performing ACO in the country this year.”

The ACO of the Year award was presented to the Southern Michigan ACO at the annual Caravan Health Accountable Care Symposium in early December in Arizona. The recognition is given based on overall improvements in quality and patient health, staff and provider engagement, and helping control costs for the patients and hospitals.

The award recognizes all the organizations that contribute as participating providers of the Southern Michigan ACO including: Hayes Green Beach Memorial Hospital, Charlotte, Mich.; Allegan General Hospital, Allegan, Mich.; Community Health Center of Branch County, Coldwater, Mich.; Deckerville Community Hospital, Deckerville, Mich.; Hillsdale Hospital, Hillsdale, Mich.; Memorial Medical, Neillsville, Wis.; Bronson South Haven Hospital, South Haven, Mich.; Sturgis Hospital, Sturgis, Mich.; and Three Rivers Health, Three Rivers, Mich.

Caravan Health is a national leader of accountable care programs for community health systems. The organization works with more than 250 health systems and 14,000 providers to improve quality and financial benefits, and develop strong physician relationships in ACOs. For more information about Southern Michigan ACO, please visit caravanhealth.com.

Hayes Green Beach Memorial Hospital has been the Charlotte community’s choice for health care for 85 years. HGB is committed to working together in health to provide quality care and enhance the vitality of the community. Learn more about HGB at www.hgbhealth.com.