Accountable Care Organizations (ACOs)

Prevent unnecessary utilization and manage multiple populations

Care Team Connect’s integrated care management platform powers your Accountable Care Organization (ACO) to consistently deliver the right care to the right patient at the right time, resulting in a sophisticated and efficient care coordination network.

For ACOs to be successful, seamless collaboration and coordination across the entire network of providers and standardization of best care practices across all care settings is crucial. Care Team Connect prevents unnecessary utilization allowing you to guide patients to appropriate resources to proactively manage their health. With Care Team Connect you will be able to create linkages with other providers including community partners electronically to share information and manage care for your patients. The enhanced communication s partner compliance with patient care plans developed from best practices and identifies opportunities for improvement. The shared patient-centric plan is accessible via Care Team Connect’s web-based platform allows providers, hospitals, community providers, family members and patients to coordinate efforts to improve patient outcomes, while significantly reducing healthcare costs.

As our ACO partners grow and add more population such as other payers, employers etc., each with a different set of program requirements, CTC’s technology platform enables our clients to scale the proven care management programs and manage multiple populations easily. Clients can streamline care management for different patient populations by having one integrated care team using the CTC platform instead of having redundant care teams and applications specific to each population. Our intuitive, scalable solution helps ACOs manage targeted patient populations by risk, payer, condition and care setting, generating individualized care plans that drive transparency and accountability across the care continuum.

ACO care managers will have the workflow solutions to turn data and protocols into coordinated care and executives will have reporting to determine program effectiveness and outcomes. The end result – a streamlined care coordination platform linking the ACO team and community partners to achieve better patient outcomes while managing costs.

Contact us to learn about the story below and the impact we have made on other ACO clients.

Client Story

Our client, an ACO that is part of a major health system in Tennessee, had a goal of achieving high quality outcomes for all attributed patients, most importantly reducing the cost of care while improving the overall care. Their attributed patient population includes three programs –employees self-insured by the health system, Medicare shared savings program (MSSP), and adult discharges from the hospitals that are part of the health system. They ultimately selected Care Team Connect not just for the flexible technology, but the program development consulting services that enabled them to design care plans for the different initiatives.
Care Team Connect staff well-versed in ACOs, employee-based and preventable readmission program requirements worked hand-in-hand with the client leadership and care managers to that both the client program and the platform configurations remained aligned with all program requirements. CTC’s program development team provides a critical assist with care plan configurations based on population definitions.

Care Team Connect imports files from multiple payers, utilizing file logic for assigning primary and secondary insurances, alerting care managers to eligible and non-eligible patients upon attribution file changes. Included with this are real-time triggers for care plans and protocols, and the requisite matching and exception reports. Care Team Connect also established HL7 ADT interfaces for the hospitals as part of their readmission prevention efforts. Care managers and care team members receive real-time alerts when attributed patients are admitted and discharged as a signal that there is a care transition to manage. Integrated data also triggers action in the form of care plan updating and protocols.

Care Team Connect’s platform serves as a crucial component of the ACO’s care management efforts, as well as the readmission prevention efforts for the hospitals. With Care Team Connect, our client has reduced their readmission rates, reduced the overall cost of care, enhanced quality of care, and streamlined care management of multiple patient populations.