State HIE Data Helps Drive Value-Based Care Across Management Org

Technologies that use health information exchange (HIE) data have helped a management service organization (MSO) improve value-based care delivery.

Cary Medical Management (CMM) oversees 40,000 patients within commercial and government value-based care contracts across 48 clinics.

The MSO's flagship primary care clinic, Generations Family Practice, achieved 32 percent below target spending for its UnitedHealthcare commercially insured population for the last plan year.

CMM's clinics have achieved an average of 21.75 percent savings across commercial and government payers who shared the data, compared to the national average savings for value-based care of 5.6 percent.  

CMM leveraged technology from health IT vendor SmartLink Health that identifies the most critical missing clinical information from specialists and hospitals from the state HIE, NC HealthConnex, and inserts it into the EHR before patient visits.

"When I became House Speaker of the great state of North Carolina, we became the first state to mandate that all providers receiving state reimbursement submit patient data to our state HIE," Tim Moore, North Carolina House Speaker, said in a press release. "I'm very pleased with the foresight of our legislature. Our investment is paying off with positive patient impact."

The MSO also implemented near-real-time discharge summaries from the HIE and proprietary patient engagement protocols. Overall, the tools have resulted in a 50 percent reduction in hospital readmission rates compared to the national average.

"It's exciting to see confirmation that our clinics are providing better patient care at significantly lower cost and being rewarded for their hard work and commitment to value," noted Siu Tong, CEO of CMM. "Our vision of empowering primary care clinics with innovative technology solutions is paying off."