The serial success of FACS Medicare and commercial ACOs can be attributed to following factors:
- A comprehensive network of over 600 independent primary care providers dedicated to the preservation of their independence and satisfaction of the FACS mission.
- A Network of over 1,000 Independent Specialists that provide clinically integrated services to Medicare and commercial patients aligned with FACS ACOs.
- Contractual Agreement between FACS and Guardian Health Services (GHS) providing access to and use of a robust HIE IT platform (referred to as Guardian) that goes beyond meaningful use and the all too common silo restrictions of independent EHRs, and reflects the “holy grail” of clinical integration.
The Guardian HIE architecture provides the capability for
1) Electronically moving clinical information among and betwee disparate providers and information systems, while maintaining the meaning of the information being exchanged,
2) Building a complete and fluid real-time view of a patient (Patient Master Chart), through longitudinal integration of patient health data/information at points of care,
3) Accessing the right information at the right time for clinical decision-making, and avoiding duplication of services and reducing medication and medical errors,
4) Optimizing compliant and audit-proof medical risk adjustment,
5) Monitoring and comparing performance relative to outcome parameters across the network, and
6) Engaging the patient through portal access to their own personal medical data, and
7) Fully satisfying the technology requirements of MIPS and APMs.
- Targeted evidence-based programs provided by GHS and driven by the Guardian HIE architecture directed at
1) Ensuring timely and effective transitions of care,
2) Analytic modeling and stratification of high risk patients with corresponding opportunities for engagement with formal complex care management services,
3) On-going identification and closure of quality performance measure gaps,
4) Effective referral management to ensure timely and cost-efficient coordination of care,
5) Systematic monitoring of medical risk adjustment and HCC coding and documentation,
6) Diversion of patients from inappropriate use of ERs, and
7) A comprehensive telemedicine program, and
8) Systematic monitoring patient experiences and satisfaction with care on the practice/provider level.
- Innovative community-based service delivery platforms that serve as high quality and cost-efficient alternative to hospital sponsored and driven platforms. A sampling of these platforms include
1) A Radiology Benefit Manager (RBM) program dedicated to integrating independent radiology centers and services and reduce unnecessary and costly imaging,
2) A hospitalist platform dedicated to providing timely, comprehensive, cost-effective, and appropriate evidence-based inpatient medical care to network patients and reduce leakage,
3) A post-acute care platform dedicated to penetrating the hospital to SNF revolving door and significantly reducing costs, and
4) a network of services/setting (e.g., radiation oncology, cath labs, outpatient surgery centers) dedicated to providing high quality and cost-efficient alternatives like services provided in hospital settings.