For a fourth consecutive year, UNC Senior Alliance is among national leaders in improving quality of care for Medicare’s most innovative alternative payment program, and has reduced healthcare costs for Next Generation Accountable Care Organization beneficiaries.
Chapel Hill, N.C. – December 3, 2021 – UNC Senior Alliance improved care for about 30,000 Medicare beneficiaries in North Carolina and saved Medicare $24.3 million by meeting quality and cost goals in 2020, according to the federal agency that administers Medicare.
UNC Senior Alliance earned a quality score of 99 percent on performance measures ranging from preventive health checks to the use of computerized health records to preventing avoidable hospitalizations.
UNC Senior Alliance is UNC Health’s statewide, physician-led accountable care organization and sister organization of UNC Health Alliance, UNC Health’s clinically integrated network and population health services company. UNC Senior Alliance consists of UNC Health hospitals, providers, and independent physicians who are shifting to value-based care to make care more accessible to patients and achieve high-quality patient outcomes at affordable costs.
UNC Senior Alliance entered into the Centers for Medicare and Medicaid Services’ (CMS) Next Generation Accountable Care Organization (NGACO) Model in 2017, and for a fourth, consecutive year earned one of the highest quality scores of participating NGACOs and has earned shared savings totaling $36.5 million over that period.
“Collaboration among healthcare providers, convenient access to primary and specialty care, and high-quality care that is affordable has never been so important,” said Dr. Mark Gwynne, President, UNC Health Alliance. “The COVID-19 pandemic challenged us to pivot quickly to telemedicine and other in-home care delivery options to ensure that patients continued receiving high-quality care and treatments to keep them healthy and safe.”
“We were successful in helping patients stay home, when appropriate,” continued Dr. Gwynne. “About 40 percent of annual wellness visits, 70 percent of nutritional therapies, and more than 75 percent of behavioral health visits were delivered through telemedicine.”
“Our population health strategies have a significant impact on health outcomes – everything from preventive care outreach to care-at-home options. Our focus is to keep patients healthy, avoid unnecessary hospitalization, and care for them in the most appropriate setting, aligned with their wishes,” said Robb Malone, PharmD, Chief Operating Officer, UNC Health Alliance. “Throughout the year, we were able to reduce unnecessary emergency department usage by 28 percent and avoidable hospitalization by 22 percent, while increasing care-at-home and telemedicine exponentially.”
The organization deploys tools and technology that identify and predict at-risk patients who may benefit from additional support and interventions from physicians or care management teams. It also leverages health data, tools, and technologies to support its provider network in outreaching to and caring for vulnerable patients with chronic conditions and ensuring Medicare beneficiaries receive the appropriate preventive care and screenings.
Eightly percent of earnings in the Next Generation ACO Model are distributed to its ACO participating providers to expand primary care and new ways to deliver the highest quality patient care. The remaining earnings are invested in expanding the population health infrastructure that supports patients and communities with case management, pharmacy, dieticians, community health workers, and in-home or telehealth services. These expanded services also help ACO participating providers with clinical quality improvement, analytics, and technologies to identify patients needing additional support, align the right services to the right patient, and enhance its network practices’ ability to care for increasingly complex patient needs.
Please visit the CMS Next Generation ACO Model web page for more information on the Next Generation ACO Model. Refer to the CMS resources page for more information on how the overall quality score was determined.
About UNC Health Alliance
UNC Health Alliance is UNC Health’s statewide, physician-led, clinically integrated network and population health services organization. It is transforming health care delivery and payment models on behalf of its provider network that includes community-based, independent physicians and those affiliated with UNC Health. With a focus on population health management, UNC Health Alliance works closely with providers, employers, and payers to manage quality, cost, and access to care for those living and working in the organization’s service areas. For more information, please visit www.unchealthalliance.org. UNC Senior Alliance is UNC Health’s accountable care organization and sister organization of UNC Health Alliance. For more information, please visit www.uncsenioralliance.org.
About UNC Health
UNC Health is comprised of UNC Hospitals at Chapel Hill, ranked consistently among the best medical centers in the country; the UNC School of Medicine, a nationally eminent research institution; Pardee UNC Health Care in Hendersonville; Chatham Hospital in Siler City; Johnston Health in Clayton and Smithfield; UNC Lenoir Health Carein Kinston; Wayne UNC Health Care in Goldsboro;Caldwell UNC Health Care in Lenoir; Nash UNC Health Care in Rocky Mount; UNC Rockingham Health Care in Eden, Onslow Memorial Hospital in Jacksonville, UNC Health Southeastern in Lumberton, CarolinaEast in New Bern, UNC Health Blue Ridge in Morganton, UNC REX Healthcare and its provider network in Wake County; and the UNC Physicians Network. For more information, please visit www.unchealth.org.