Disease Management Wins Drive Essentia Toward ACO

With all the negative chatter about accountable care organizations from healthcare leaders and in public comment forums, it is interesting to see which healthcare systems are ready to leap at the chance to initiate ACOs.

Often the ones at the head of the pack are the ones who feel their current systems are so locked in and on target, that they seemingly can't wait to get started.  

The Essentia Health System in Duluth, MN seems to have that attitude. Essentia is getting ready to transition to an ACO after receiving data showing the effectiveness of its disease management program. While national heart failure readmission rates are  about 40 to 50% range, the sickest heart failure patients in Essentia's program have admission rates between 0 and 2%, says Linda Wick, NP, RN, manager of the Essentia Health System's heart failure program, formerly known as St. Mary's Duluth Clinic Heart Failure Program.

Readmission rates were estimated at 3% to 7%.

One of the most significant aspects of care that the system does, and does successfully, is disease management, working with the patients, tying that in with a telemonitoring scale program linked to patients with cardiovascular conditions, says Wick.

"Disease management is the thing," she says. "I think a lot of people don't fully understand what that means. We look at patients with the understanding we are responsible for them 24/7," Wick said.

She is a nurse, and from that perspective Wick says the nurses have guided the process of the disease management program, especially in ensuring follow-up care. "We are giving patients the skills and resources they need to manage their own disease, and they know we are available," she explained.

Under the program, the hospital has reduced 911 calls and admittances to the emergency departments, as well as showing hefty savings, she said. An Essentia Health study with Blue Cross Blue Shield of Minnesota revealed $1.25 million in healthcare savings for evaluation of 29 patients over a six-month period, according to Wick.