Press Release

Texas ACO Generates $14 Million in Savings and Achieves Perfect Quality Score

ACO, primary care physicians and care managers partner with Lightbeam Health Solutions to yield dramatic cost savings and quality of care enhancements for more than 5,000 patients in South Texas

IRVING, Texas – Jan. 24, 2017 – Rio Grande Valley Health Alliance, LLC (RGVHA), an accountable care organization (ACO) based in McAllen, Texas, is achieving significant cost savings and quality improvements spearheaded by area primary care physicians who have partnered with population health technology provider Lightbeam Health Solutions.

The ACO is composed of 18 primary care physician practices working with the Centers for Medicare & Medicaid Services (CMS) to provide coordinated care to Medicare patients in the Rio Grande Valley of South Texas. Since it began operating as an ACO in 2013, RGVHA has saved more than $28 million – nearly $14 million in 2015 alone – by better stratifying and serving its population with tools from Lightbeam.

“Lightbeam’s value to our ACO goes beyond population health software because we benefit just as much from Lightbeam’s knowledge and best practices for orchestrating proactive and efficient work by physicians and care management teams. Lightbeam helps us stay a step ahead of our populations’ health needs, which lets us deliver both quality and cost savings that we’re very proud of,” said Victoria Farias, assistant administrator at Rio Grande Valley Health Alliance, LLC. “We continue collaborating with Lightbeam to identify and address new ways of cost-effectively providing high-quality care, especially for those patients with the most acute and chronic conditions.”

In the recent ACO Financial Report from CMS profiling results from the 2015 Medicare Shared Savings Program (MSSP), RGVHA was also one of only four ACOs in the nationwide program to achieve a perfect 100-percent quality score. These results were due to the ACO working with a scorecard system based on Lightbeam quality measures that also targeted non-compliant patients so care teams could more proactively manage those individuals’ care.

“We’re proud to partner with Rio Grande Valley Health Alliance to find ways to reduce healthcare costs while identifying patients whose lives can be improved simply through heightened healthcare education and more proactive care coordination,” said Pat Cline, CEO of Lightbeam. “The Lightbeam platform helps ACOs like Rio Grande risk-stratify their populations to a granular level and our tools deliver that reliable data to care teams that use it to move more quickly and decisively to close care gaps, increase patient engagement and reduce cost. We believe that Rio Grande is an excellent blueprint for other ACOs looking to deliver similar savings and quality scores.”

Highlights of the RGVHA ACO’s success include:

  • Decreasing home health spending by 41 percent
  • Reducing emergency room visits and associated hospitalizations by 10 percent
  • Viewing patients’ underlying data, comparing it to CMS home health criteria, and identifying patients who qualify for alternative avenues of care
  • Improving care coordination across the health system and connecting area providers to better manage various patient populations

A key next step for the ACO is deploying the Lightbeam Cohort Builder to help RGVHA further identify high-risk patients who can enroll in various evidence-based care programs to improve patient outcomes and lower costs. Cohort analysis assists ACOs and providers by giving clear guidance and prioritizing where care management and other efforts should be focused.

About Rio Grande Valley Health Alliance, LLC
Founded in 2012, Rio Grande Valley Health Alliance (RGVHA) is an 18-member ACO working with Medicare located in the Rio Grande Valley of South Texas. The ACO is made up of 16 independent practices focusing on primary care for approximately 5,500 patients in the McAllen, Texas, area.

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