Population Health Management and Quality Improvement Programs

· Volume 3, Volume 3 Issue 1

The Accountable Care Organization results: Population health management and quality improvement programs associated with increased quality of care and decreased utilization and cost of care

Authors: O’Donnell, Ronald; Anand, Nishant Shaun; Ganser, Caroline; Wexler, Nancy

Objective: The Accountable Care Organization (ACO) model of health care delivery is based on new payment models for general practice to reward improved quality and decreased cost of care.

Methods: Banner Health Network (BHN) is one of the original CMS Pioneer ACO programs and implemented a comprehensive disease management program based on the collaborative care model. Key performance indicators for CMS reflected quality and cost of care.

Results: BHN has demonstrated both improved quality and cost savings in the first two years of the pilot program. The disease management program based on the collaborative care model appears to have improved patient health outcomes based on quality improvement measures. In addition the program has reduced emergency department and hospital utilization, resulting in cost savings.

Conclusions: The BHN quality improvement program is the platform for analyzing and improving on the BHN ACO model. This model appears to have excellent application to the China health care system that is also focused on prevention and improvement of chronic disease and cost-effectiveness.