The Florida Association of Accountable Care Organizations (FLAACOS) kicked off their annual conference on November 7th at the Omni Orlando Resort at Champions gate in Orlando, FL. As a Platinum Sponsor, the Salient Healthcare team came to support the ongoing efforts of the very successful Florida-based Accountable Care Organizations (ACOs).


The FLAACOS conference began with an opening speech made by the Board Chairman, Nicole Bradberry, Founder of CURA Health Management. Bradberry addressed the ACO state of the union, celebrated FLAACOS’s 7th year as an organization, and proved that once again, Florida ACOs are most successful. I found it astounding that 72% of Florida ACOs saved money in 2018 and 56% of Florida ACOs made shared savings that totaled close to $500 Million. There are a number of factors that contribute to the success of the Florida ACOs including high benchmarks, experience with HMO contracts, or even the mere fact that the majority of Florida ACOs began in 2012/2013 and with experience, comes success.

Directly following the opening speech was the keynote addressed by Aneesh Chopra, the President of Care Journey, former CTO of the United States, and former Secretary of Technology for the state of Virginia. Entitled, “Connecting the Dots,” Chopra’s presentation pressed on the urgency of our healthcare’s need to shift to value-based payment. Some interesting takeaways that align with some of the work we are doing with our clients was around Part B drugs. Injectables are notoriously costly, and two ophthalmology injections for macular degeneration in particular, Eylea and Lucentis, come to forefront of the discussion. The average cost for this drug is about $2,000 per injection, while the generic, Avastin, may only cost about $60. By utilizing public data, anyone is able to see how much practitioners are paid through their Medicaid or Medicare contracts. As expected, the highest grossing practitioner was an ophthalmologist earning millions of dollars due to reimbursements tied to those very expensive injectables, while a significantly less expensive and effective alternative is available. To achieve the triple aim, these studies need to come to the forefront to decrease costs, increase better outcomes by providing high quality of care and increasing patient satisfaction.

Chopra also discussed the use of data to provide better care through patient engagement. For example, Social Determinants of Health information can be enhanced by utilizing hot spots or zip code-related data to help connect patients with necessary resources. Lastly, he spoke about the use of Blue Button data to assist the Medicare population in deciphering which plans would be best. For example, patients can opt for Humana to access their patient information and help them decide which plan would work for them based on the medications they were on and other care they needed.

Directly following the Keynote, came time for the Salient-sponsored presentation with Holy Cross Physician Partners (HCPP), entitled, “Post-Acute Care Pathways: A Joint Case Study on Network Utilization.”  Kelly Conroy, the ACO Executive Director and I presented a case study on the importance of developing and maintaining what Conroy calls, a high caliber network–one that has high quality, low costs, and high patient satisfaction.  We went through the Florida landscape which showed how much choice Medicare patients have for healthcare services before diving into the case study where we measured the baseline utilization of acute and post-acute care, walked through all of the interventions and initiatives HCPP had to encourage preferred or in-network utilization for post-acute care, and then revisited the initial baseline data in the evaluation period to monitor the change in network utilization. The case study revealed that it is possible to shift patients under Medicare to a preferred network, but the shift happens gradually over time. It is extremely important to have provider buy-in in the process so that they may properly educate patients on the preferred choice for care with emphasis on safety. The movement from out of network utilization for skilled nursing facilities to the preferred network was a savings of about $2,000 per episode and likewise, for home health agency, the shift resulting in an average savings of about $1,200. Ultimately, in one year, HCPP saw a savings of about $500,000 by simply shifting patients to the preferred network, and these savings are expected to increase exponentially over time.

While I only highlighted Chopra’s keynote and the joint case study I completed with Kelly Conroy at the FLACCOS conference, there were a few other memorable presentation topics including: direct contracting, primary care first, social determinants of health, pathways to success, and behavioral health to name a few. There were many takeaways to incorporate into the way I think about healthcare and how I will advise clients moving forwards. Overall, it was a successful conference and we look forward to next year’s event.

Amy Kotch

About the Author

Amy Kotch, MHA

Amy Kotch is Salient’s Lead Business Consultant working with ACOs nationwide. She received a masters in health administration from Florida Atlantic University as well as a bachelors of science from the University of Miami and has just recently completed a master certification in population health through a federal grant from the Office of the National Coordinator for Health Information Technology in conjunction with the Johns Hopkins University and Normandale Community College. Her prior work includes being the operations coordinator at Triple Aim Development Group consulting with ACOs/MSOs.

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