Three Lincoln clinics have formed an Accountable Care Organization, a new model of health care that focuses on wellness and preventing unnecessary hospitalizations.
The three clinics, which are part of OneHealth Nebraska, are Lincoln Internal Medical Associates, Nebraska Internal Medicine and Primary Care Partners.
In Accountable Care Organizations (ACOs), physicians are rewarded for improving the health of their patients, improving customer service and preventing avoidable health complications, according to a news release.
The three Lincoln clinics' first contract is with Medicare and could be expanded to other insurance groups.
Instead of getting paid per patient and per procedure, the clinics are paid for preventing complications that land people in the hospital, said Dr. Bob Rauner, chief medical officer.
"They pay us on the savings generated," he said. If clinics take better care of patients and make them healthier, then Medicare splits that savings with the clinics," he explained.
Healthy patients won't see much difference in care, except perhaps more focus on their annual wellness visit.
But people with chronic health issues — heart failure, for example — will get more phone calls from the doctor's office to check on their situation, he said.
This approach is a win-win for patients, health care providers and those who pay for health care, according to a news release on the new contract.
OneHealth Nebraska ACO is Lincoln’s first locally owned and managed Accountable Care Organization, the release says.
The Medicare contract will begin in January, Rauner said.
As part of its contract with Medicare, the governing board that provides local oversight includes patients from the community who are covered by Medicare. Former state senator and chair of the Legislature's Health and Human Services Committee Kathy Campbell and former Lincoln/Lancaster County Board of Health president Dr. Ed Schneider will serve these roles on the OneHealth Nebraska ACO board of directors.
"As a former health care provider and a Medicare recipient myself, serving on the board of an organization that seeks to improve the quality of care provided to their patients while reducing health care costs is something I am proud to help lead,” Schneider said in a news release.
The clinics forming OneHealth ACO have been working on community health improvement projects in Lincoln and were active participants of the Nebraska Physicians Cancer Screening Project, which is working to improve cancer screening rates.
Cancer screening rates for Lancaster County lead the state and the three clinics' cancer screening rates were competitive with some of the best ACOs in the country, which spurred lead physicians Drs. Jason Potts, Lincoln Internal Medicine Associates; Don Schmidt, Nebraska Internal Medicine; and Brandon Webb, Primary Care Partners; to pursue forming an ACO, said Schmidt.
“OneHealth Nebraska will coordinate care to ensure our patients, especially those with chronic diseases, get the right care at the right time in a cost-effective way. We all benefit from that,” he said.
Leading the organization will be Steve Kros, chief executive officer, and Rauner, who will serve as chief medical officer.
Rauner will split his time between OneHealth Nebraska ACO and his current job as President of Partnership for a Healthy Lincoln.
The clinics are part of the broad OneHealth Nebraska network of about 300 independent Lincoln physicians. The organization gives the smaller clinics the advantage of a larger organization in things such as negotiating with suppliers and insurance companies.