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Banner Health’s ACO Model for Case Management

Many observers, including the analyst firm IDC Health Insights, have noted the critical role of care management software in accountable care organizations (ACOs). For a closer look at how one health system has used care management technology to create the foundation for an ACO, we recently read this excellent peer-reviewed article (requires download fee or subscription to Professional Case Management) by Linda Stutz, BSN, MBA, Senior Director for Case Management at Banner Health.

In the article (“Case Management as a Foundation for an Accountable Care Organization”), Stutz describes how Banner, one of the largest, nonprofit health care systems in the country, implemented “a Case Management Model that demonstrates a strong return on investment for the hospitals in the system and creates the foundation for success under health care reform.”

Just what ROI did Banner produce under the new model?

  • An 8-percent drop in average Length of Stay (LOS), from 4.31 days to 3.99 days  
  • Improved retrospective short-paid claims, delivering a total of 60,880 total potential saved days across the 11 hospitals that participated in the initiative.

These numbers, Stutz notes, “translate into a significant annual reduction in controllable expenses.”

You may be wondering what exactly defines Banner’s new case management model. From a 500-foot level, Banner broadened and deepened the traditional role of case management. Rather than managing acute-only events, Banner’s new case management team emphasizes a multi-disciplinary approach to following the patient “throughout the continuum and between the transitions in care,” Stutz writes.  

In other words, the health system adopted exactly what’s needed for an ACO to improve quality and reduce costs across multiple acute, ambulatory and post-acute facilities (for an ACO, cost-savings equal profit).

Stutz notes that a key contributor to the success of the new model is Banner’s system-wide Allscripts Care Management solution.  The Web-based solution, deployed in all 22 Banner hospitals in just eight months, helped the health system develop “one workflow with a standard set of data definitions to provide standardization and reduction in variation of care,” Stutz writes. “This creates a central database for easy reporting. Data then drives decisions and performance.”

The implications for Case Management, she continues, are clear: “A standardized system infrastructure for case management improves LOS, improves patient throughput, reduces utilization and costs, improves patient satisfaction, and creates a foundation for financial success under health care reform.”

QUESTION: What changes is your organization making to prepare for accountable care? 

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