NHN to Present at CMS Learning Collaborative
Published Aug. 31, 2020
Nebraska Health Network to Present at Regional CMS Learning Collaborative
Local ACO to Demonstrate the Importance of Risk Capture
(Omaha, Neb., 8/31/2020): The Centers for Medicare and Medicaid Services, together with Mathematica and the Institute for Healthcare Improvement, are holding a virtual regional learning collaborative to bring together Accountable Care Organizations on Sept.17. The learning collaborative enables participants to exchange ideas and potential solutions for mutual challenges in health-care systems.
Nebraska Health Network, the accountable care organization for Methodist Health System and Nebraska Medicine, is one of the featured ACOs. Jimmy Johnson, NHN manager of IT and analytics, and Chern Chuan Soo, NHN senior analytics consultant, will discuss how and why ACOs should prioritize improving Hierarchical Condition Category (HCC) risk capture.
HCC coding is a risk-adjustment model originally designed to estimate future health-care costs for patients. By capturing HCC codes along with demographic factors such as age and gender, insurance companies assign a risk adjustment factor score to patients. The score helps the ACO understand how sick patients really are; the sicker the patient, the higher the risk score and higher projected cost to treat the patient. Cost targets are then set to align with the illness burden of the entire population. This approach enables ACOs to pro-actively manage high-risk patient populations.
“By capturing risk scores on patients, we can communicate how sick a patient is to insurance companies,” Johnson said. “This helps accurately set cost and quality targets in value-based contracts.”
Johnson and Soo will demonstrate how Nebraska Health Network is using their HCC data method to benefit providers, patients and insurance companies and how to replicate the method across the country.
About Nebraska Health Network
In 2010, two leading health systems in Nebraska -- Methodist Health System and Nebraska Medicine -- partnered together to create the Nebraska Health Network Accountable Care Organization. As an ACO, the Nebraska Health Network improves care coordination among the entire care team including primary care providers, specialists and hospitals. NHN is leading the transformation to a value-based care model where health-care providers, hospitals and insurers are focused on quality and cost initiatives that strengthen the patient experience.
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About the NHN
Formed in 2010, Nebraska Health Network is the accountable care organization for two leading health systems in Nebraska: Methodist Health System and Nebraska Medicine. We have more than 5,500 primary care and specialty physicians and advanced practice providers working throughout the Omaha metropolitan area, Fremont and western Iowa. Together, we work to transform health care and provide patients with the highest possible quality of care at the lowest cost.
SUBJECT MATTER EXPERTS
The NHN team welcomes the opportunity to speak with you on a number of industry topics including, but not limited to:
- Value-based Care
- Advanced Payment Models
- Cost and Quality Initiatives
- Medicare Shared Savings Program
- Social Determinants of Health