Reducing home health care costs through a preferred agency network for an accountable care organization

Allways Health Partners was recently featured in a case study published by the New England Journal of Medicine. Keep reading to learn how we created an integrated ACO model that facilitates care coordination for our members while addressing overutilization of costly health services. 

This case study was originally pubilshed by NEJM Catalyst Innovations in Care Delivery.

In 2018, leaders of the Greater Lawrence Family Health Center and Lawrence General Hospital partnered with AllWays Health Partners, a health plan, to form the Medicaid accountable care organization (ACO) My Care Family, which serves about 39,000 patients in the region. To address concerns about the overutilization of home health care services in the Merrimack Valley of Massachusetts, the ACO intentionally aimed to control costs through the creation of a Preferred Agency Network. Patient referrals would be limited to a selected group of home health agencies that actively created prudent care plans to provide the care needed for patients to remain in the community. ACO leaders developed relationships with these agencies to coordinate better care for these shared patients. Within 6 months, home health services were reduced by about 75%, and within a year, patients’ home health, inpatient, and emergency department costs were cut nearly in half.

Read the full case study on the New England Journal of Medicine website.

Authors: Dr. Laura K. Minardi, and Dr. Christine Rooney