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Tracking ACO Patients

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Last Post by rwilliams 8 years ago

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Sirna

(@sirna)

Posts: 384

Honorable Member

Topic starter

We are checking to see how everyone who is part of an ACO is tracking the patients they have attested to it. We are checking with GE to see what our options are, but wanted to see what workflows folks have used and worked for this tracking.

Thanks!

Sirna

Posted : February 22, 2017 3:27 am

bhoover

(@bhoover)

Posts: 360

Honorable Member

Hi,

One of the simple things that we are doing is that if the patient has medicare listed as their insurance we are showing a prompt on our HPI form. We also show a prompt in a similar manner in our patient banner.

Brad

Posted : February 22, 2017 4:23 am

Sirna

(@sirna)

Posts: 384

Honorable Member

Topic starter

Are you using a custom HPI form or the HPI-CCC? If so with the HPI-CCC, did you customize it to reflect this?

Posted : February 22, 2017 4:31 am

bhoover

(@bhoover)

Posts: 360

Honorable Member

We are using a custom HPI form. Our providers do not care for the CCC content. All we did was add a visibility region to our form with the following:

{INS_PLAN() == "MEDICARE"}

If this returns as true the provider sees a large block of text with: "ACO PATIENT".

Posted : February 22, 2017 4:36 am

rwilliams

(@rwilliams)

Posts: 454

Honorable Member

We populate the OBS term ACOMEMBER with the NPI number of the attributed provider or the word Inactive if the patient has left the ACO. We have some logic in the banner that states that if it is blank or inactive to display "ACO: No" otherwise it is Yes.

The tricky part was updating the list every quarter. We have around 12k patients in our ACO and a few thousand get added and removed each quarter. I wrote an interface that uses the data provided by medicare in a CSV to search for the patient by HICNO/DOB/NAME etc and if it finds the patient it generates an HL7 file that gets imported into linklogic for the ACOMEMBER observation. I usually have a handful of messages that have to be worked by hand each quarter.

Posted : February 23, 2017 10:20 am

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