Baystate Health finds ACO success with help from its own startup
Baystate Health in Springfield, Massachusetts, has been focusing on value-based care for quite some time. As a Next Generation Accountable Care Organization and a participant in the Centers for Medicare and Medicaid Services' Bundled Payments for Care Improvement program, it’s important for the health system to know what’s happening with its patients beyond the hospital walls.
One of the early advantages Baystate had was its healthcare technology innovation center, TechSpring. TechSpring works with stakeholders in the health system to identify "passionate problems" in today’s environment and attempts to find innovators or companies that have been working on "transformative solutions" that can address them.
TechSpring partners with these innovators and facilitates a project between them and the healthcare stakeholder, in an effort to help them prove – and improve – their solution in a real-world healthcare environment.
This ultimately brings a user-validated solution to market more quickly, said Joel Vengco, senior vice president and CIO at Baystate Health.
"Once Baystate identified the passionate problem of gaining more insight into what happens to our patients when they leave the hospital, TechSpring brought on CarePort, which at the time was a late-stage startup, as an innovation partner," Vengco explained. "CarePort worked with us for a year to test and improve its solution, working with our inpatient case managers, our visiting nurse association, and our post-acute facilities."
By the end of the process through TechSpring, CarePort Guide developed in such a way that it helped Baystate Health significantly improve the discharge process at its 700-plus bed medical center in Springfield.
"TechSpring worked closely with CarePort to implement and optimize CarePort Guide for Baystate," he said. "In fact, we were the first to use it. This was a collaborative process that gave us the opportunity to give input into and shape a tool that we wanted and needed for post-acute coordination.
"As part of the TechSpring model, BayState staff and patients were involved in the platform development, which now gives case managers access to a searchable database of certified Medicare post-acute providers," he added.
They can search by their patient’s insurance, clinical services, bed availability and more, and results can be easily shared with patients or even e-mailed to family members or other caregivers. Patients get to review all their options and make an informed decision about where they’d like to go before the case manager has to finalize the plan and submit the referral.
CarePort Guide now comes into the picture every time Baystate has a patient who is ready to be discharged from the hospital but who is not quite ready to go home yet. So, they’re being discharged to a skilled nursing facility, a rehab facility or perhaps home health.
"We like to start these conversations with patients as early as possible, ideally a few days in advance of discharge," Vengco said. "Our case managers talk to the patients to understand what’s important to them – that might be the amenities of a facility, a location that keeps them close to family or some other caregiver, or an insurance restriction, and of course the quality of care provided – and then search for a facility that has availability, meets these criteria, and also meets the criteria for clinical care for that patient."
The CarePort Guide tool has a simple interface, similar to a website like Hotels.com, and case managers can either review it with the patient or send direct links for the patient to review and then submit the referral. They can do all of this without leaving the system, which was something staff had highlighted as critical during the beta-testing phase through TechSpring.
Patients used to select post-acute providers from a generic paper list of names and addresses. They didn’t have any information on quality because case managers lacked an up-to-date provider directory with this information.
Oftentimes the selected facility wouldn’t even wind up being able to take the patient because of the patient’s insurance, because they weren’t equipped for the patient’s specific needs, like dialysis for example, or simply because they had no beds free, which Baystate wouldn’t know on its end.
"Working with CarePort through TechSpring’s innovation model allowed us to share these problems and describe what we needed the technology to be able to do to solve them," Vengco explained. "We beta-tested Guide at Baystate to make sure it had everything we needed to help us understand which facilities will work for our patients. Today Guide lets our patients take virtual tours, share information with family members, and more, greatly improving the post-acute care selection process."
The results of using this technology, particularly as it developed with staff input through the collaboration between CarePort and TechSpring, are readily apparent, Vengco said.
"We’ve seen improvements in our average length of stay for inpatient, which is very important for us as ACO and bundled payment program participants," he explained. "You don’t see the typical delays that occur when patients and families are trying to make these tough choices in a vacuum, and the case managers have higher throughput because they’re not wasting time making phone calls, leaving voicemails, and checking faxes."
Patient satisfaction with the process also has seen dramatic improvement, he reported. Additionally, the post-acute outcomes are improved because of the ability to guide patients to facilities that are of high quality and fit the needs of the patient and the family, he added.