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South Florida based Accountable Care Organization Partners with Leader in ACO Management
Orange Accountable of South Florida (OACSF) sets sights on making an immediate impact on healthcare cost through the innovative programs and technology developed by Jacksonville, FL based Orange Health Solutions (OHS).
By: Orange Health Solutions (OHS)
Prior to founding OHS, Bradberry was a founding Executive and Chief Information Officer for Rise Health, where she led the design and implementation of a full primary care transformation suite of products which included proprietary technology and transformational business solutions. In this role, she led her team to win the prestigious U.S. Department of Health and Human Services health data award for IT innovation. Prior to Rise, Nicole spent 16 years leading quality and affordability programs and large scale operations and information technology for UnitedHealth Group and Cigna HealthCare.
Exposito also joins this partnership with an extensive 25 year healthcare background. She began her career as an orthopedic nurse at Jackson Memorial Hospital where she went on to become a Utilization and Quality Assurance Coordinator, granting her the skills and firsthand experience necessary to educate physicians on regulations for decreasing length of stay, citing proper documentation to meet government criteria, and assisting physicians with tools for proper discharge planning. After receiving a Master's Degree in Health Services Administration, she helped launch MediPro Home Health Services, later becoming Director of Patient Services for VNA of Dade County. Lissette continues to work in the home health arena and closely works with many physician practices by enhancing their patient retention, education, and transition of care from hospitals and other facilities.
As healthcare shifts from a fee-for-service model to one that rewards outcomes, ACOs are one of the models paving the way. They are part of the Centers for Medicare and Medicaid Services (CMS) cost-sharing program established to counteract uncontrolled costs associated with the traditional fee-for-pay system. Within the ACO, physicians will share patient information, allowing coordination of care. To qualify, an ACO must manage the health care of at least 5,000 Medicare patients and meet 33 quality measurements. In return the ACO participants will share monetary savings with CMS based on the reduction in medical costs the ACO will achieve.
“OHS has established and partnered with independent Medicare ACOs throughout the country, while developing innovative and scalable technology, analytics and service models in line with the 'triple aim'—achieving better population health, providing higher quality of treatment and reducing the costs of care,” says OHS co-founder and President Nicole Bradberry. “With OAC of South Florida we have formed our first ‘franchise’
OHS delivers a unique and comprehensive, technology powered, people driven solution - one designed to identify and incorporate medical cost management across all phases of care delivery from patient intake, pre-visit preparation, all the way through care coordination and follow through. OHS begins and ends with medical cost management, and continually focuses on the data by analyzing medical cost opportunities, combining claim and clinical data to prioritize and identify opportunities to improve both medical cost and quality at the patient level.
“To achieve our goals as an ACO, we need to align infrastructure, analytics capabilities, operations, and physician engagement, essentially changing the fundamental nature of the healthcare business,” said Lissette Exposito, President and CEO of Orange Accountable Care of South Florida. “OHS had already designed and demonstrated success in getting ACOs up and running quickly to meet CMS requirements, at the same time building a foundation that has the ability to adapt as our ACO grows.”
Exposito and Bradberry chose to focus on Southeast Florida because it ranks among the most expensive Medicare markets in the United States. 59% of patients in the Miami market see 10 or more physicians in their last six months of life, which is 17% higher than the national average. They firmly believe their focus on medical cost management centered around the patient will reduce costs while improving overall patient health and patient satisfaction, and consequently result in shared savings and success for both their organizations.
About Orange Health Solutions
Orange Health Solutions is forging the new era of healthcare by focusing on proactive care management and care coordination, supported by best-in-class patient engagement and evidence-based guidelines. Orange Health believes that healthcare is a journey that is personal yet socially connected, and a lifestyle not a reaction. Visit the OHS Website at www.orangehealth.net . OHS can also be found on Facebook at www.facebook.com/
About Orange Accountable Care of South Florida (OACSF)
OACSFL is a Medicare approved ACO participating in the Medicare shared savings program starting 1/1/2014. It is made up of independent primary care physician practices in the South Florida market. Current membership is over 9,000 Medicare beneficiary lives.
Kristi R. Stovall, OHS - VP, Marketing & Branding