FEATURE · POLICY & VALUE-BASED CARE
The Keys to CentraCare’s Success as a Medicaid ACO
By David Raths
CentraCare has had particular success as a Medicaid accountable care organization. During the recent NAACOS spring confer- ence, Rachael Lesch, R.N., M.B.A., executive director of population health and quality at CentraCare, discussed her team’s approach to value-based care in the Medicaid space. Lesch said nine-hospital CentraCare’s
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Medicaid ACO has by far been its most successful value-based contract. “We have saved the State of Minnesota over $100 million over the last five years.” One thing that they believe is a key
driver with the Medicaid population is a very intentional patient engagement strategy. “We can't serve the patients that we're not seeing,” Lesch said. “I have a whole team of people — they're small but mighty — who do over 60,000 patient outreaches a month to ensure that we're seeing our patients for their care gaps and coding gaps if they're not connected to our primary care network. This is really big in
ith a wide variety of value-based care experiences, St. Cloud, Minn.-based health system
“We can’t serve the patients that we’re not seeing. I have a whole team of people — they’re small but mighty — who do over 60,000 patient outreaches a month to ensure that we’re seeing our patients for their care gaps and coding gaps if they’re not connected to our primary care network.” — Rachael Lesch, R.N., M.B.A., executive director of population health and quality at CentraCare
the Medicaid population. Over 50 percent of our 50,000 Medicaid members are under the age of 18. So that wellness strategy for well-child visits is very important — mak- ing sure that we're getting relatively well patients and members in for visits but also making sure that we keep them attributed to our particular health system because there can be a higher level of churn in a Medicaid contract.” Access to behavioral health and sub-
stance use treatment is also key, Lesch added. “We have a large behavioral health infrastructure within our health system,
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but we also connect with lots of behav- ioral health providers. Whoever is able to serve that patient first is the priority,” she explained. “We also know that this con- nects to a lot of social drivers. For example, patients in our ER who are being treated for substance use disorder, opioid disorder, overdoses — a third of that population is actually experiencing homelessness. They need connection to our community health improvement resources.” CentraCare also has an integrated
strategy with correctional medicine in some of its counties with high Medicaid
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