Sound Physicians, a physician-led national medical group with more than 4,000 clinicians in 400-plus hospitals across 45 states, has launched Sound Long-Term Care Management (SLTCM), an accountable care organization focused on caring for Medicare beneficiaries who are residents of long-term care facilities.
Officially approved by the Centers for Medicare and Medicaid Services (CMS), the ACO launched Jan. 1. SLTCM is a Medicare Shared Savings Program (MSSP) Enhanced Track ACO.
"Our ACO model focuses on the most vulnerable, highest acuity, and under-supported Medicare population by bringing together clinicians, facilities, data, and technology to drive quality," said Mike Camacho, president of accountable care for Tacoma, Wash.-based Sound Physicians. "When we lead with quality, patient care will improve."
Under the leadership of Camacho and John Dickey, M.D., chief medical officer of SLTCM, Sound said it would draw from its decade of value-based care expertise to help participating physicians and facilities improve performance.
Of the 1.3 million long-term care residents in the U.S., less than 10 percent are enrolled in a population health program. The complexity, lack of access, and high cost of treating these individuals have typically left them out of the mix when it comes to population health initiatives such as ACOs, according to Sound Physicians.
"We're managing a very complex patient population," said Camacho, noting that preliminary data from Medicare shows the patient mortality rate at 27.25 percent, compared to the national community-based ACOs of 3.15 percent. SLTCM patients are battling septicemia, dementia, and other catastrophic diseases at a rate 11 to 15 times greater than the average Medicare ACO beneficiary. For SLTCM, working hand in hand with providers and facilities can make a significant positive impact on care for these patients.
With the cost of care per beneficiary at $35,000 annually, there's a significant opportunity to reduce the financial burden — on patients and the healthcare system overall. Sound's goal is to improve patients' quality of life and reduce costs through annual wellness visits, chronic care management, and point-of-care technology, as well as employing Sound's telemedicine solution broadly in skilled nursing facilities to help prevent avoidable admissions and readmissions by treating patients in place. Sound said its telemedicine program overall has demonstrated a 96 percent success rate with treating patients at its facility versus having to admit them to the hospital.
"It really does extend Sound's vision to meet our patients who are most in need," said Dickey in a statement.
Sound said the model will help hundreds of physicians and their facility partners achieve quality metrics with education, resources, workflows, technology, and improved care coordination. Sound said ti offers near-real-time data reports for participating physicians to help adjust course and drive behavior changes to align toward consistently better patient care.
