UCSF Health: Meet BPCI Goals with Automated Episodic Outreach

As a part of UCSF’s Vision 2020 and mission to tackle the biggest challenges in healthcare, the system has set the goal to become a high-value system of healthcare, focused on providing value-driven care by participating in alternative payment models. Since 2013, UCSF has partnered with CipherHealth to engage target populations across the care continuum.

CHALLENGE

In 2015, UCSF’s Office of Population Health and Accountable Care (OPHAC) partnered with the Department of Orthopedic Surgery to move from the Bundled Payment for Care Improvement (BPCI) Model 4 to Model 2. Model 2 is a retrospective arrangement where actual expenditures are compared against a target price for an episode of care. Because this episode includes the inpatient stay in an acute care hospital and the 90 days post-discharge, UCSF needed a cost-effective tool to ensure patients have the necessary support, education and resources to recover throughout the episode.

SOLUTION

In 2016, UCSF expanded their use of CipherHealth’s CipherOutreach technology to engage patients through their episode of care. Through an integration with UCSF’s EMR, patients eligible for bundled payment outreach were identified. Once discharged, patients received eight automated CipherOutreach calls throughout the 90-day episode, asking tailored questions about their recovery. When a patient indicated a concern on any of the calls, such as needing help scheduling a follow up appointment, a real-time alert was sent to the centralized team within OPHAC for timely follow up with the patient. Data from the program has enabled UCSF to improve collaboration with clinically integrated network partners such as primary care, post-acute care and specialists.

RESULTS

From July 2016 to March 2017 CipherHealth called 1,347 patients, exceeding their goal of reaching 75% of patients. Alongside other population health initiatives, the CipherOutreach programs helped to reduce 90-day readmissions for elective cases by 37%. SNF utilization and inpatient rehab utilization were reduced by 23% and 58% respectively. Additionally, UCSF Health OPHAC lowered the Anchor Length of Stay from 3.49 days to 2.32 days. These results helped achieve $958,664 in total savings representing an average saving per episode of approximately $2,800.

Results of Implementing Strategic Initiatives for BPCI

CLIENT: UCSF Health, PROFILE: Academic Medical Center Participating in BPCI, PRODUCT: Episodic Outreach, PROGRAM: BPCI Follow Up, DATA PERIOD: Jul 2016 – Mar 2017