Northeast Medical Group announces improved quality, excellent patient experience and higher shared savings

Stratford, CT (Oct. 13, 2021) – Northeast Medical Group (NEMG), part of Yale New Haven Health, has announced that successful efforts to enhance quality of care, better coordinate care and deliver superior patient experience have led to over $13 million in shared savings from the Centers for Medicare and Medicaid Services (CMS) in the past year.

NEMG is an accountable care organization (ACO), which means care teams coordinate care in order to improve outcomes for patients and reduce overall cost of care. In order to achieve shared savings through the program, ACOs must not only reduce cost but also achieve high levels of quality of care and patient experience.

Through the work of dedicated clinicians and care teams, NEMG has continually improved quality scores for patient care, year over year, achieving a score of 98.44 out of 100 for the year 2020, despite the occurrence of the COVID pandemic. Ambulatory patient experience scores were sustained above the 90th percentile nationally (top 10 percent in the country) during the same period.

Of the 18 accountable care organizations in the region, NEMG achieved the highest total savings for CMS. NEMG was second in the region for savings rate, shared savings amount and third for total enrollment of over 26,000 beneficiaries. “The past year 2020 was exceptionally challenging for hospitals and patients due to the COVID pandemic,” said Kathleen Madden, NEMG executive director, Accountable Care Organization/Value-Based Programs. “It was more important than ever to reach out to vulnerable patients and those over 65.”

Kathleen Madden, NEMG executive director, Accountable Care Organization/Value-Based

“As NEMG pivoted much care to “virtual,” or video-based, visits, we were able to complete annual wellness visits – the gold standard for a comprehensive care visit – for 81 percent of our most vulnerable patients,” said Arnold DoRosario, MD, NEMG vice president and chief population officer.

Arnold DoRosario, MD, NEMG vice president and chief population officer

“While this has been a team effort involving clinicians and staff, NEMG’s preventive health coordinators deserve special mention, Madden said. “In 2020 they completed 7,715 outreaches to ACO patients on a variety of topics such as completing annual wellness visits, follow up for chronic conditions and discussing risk factors if they became ill.”

NEMG clinicians, particularly those in primary care, worked with care teams to ensure priority went to at-risk patients who had not been seen recently. Their consistent focus on evidence-based care helped to ensure highest quality. Focus on helping patients with specific chronic conditions, such as diabetes, significantly improved associated measures, as patients received individual outreach, support and coaching.

The ACO has been increasing their quality scores for the last four years, moving from 86.65 in 2017 to 98.44 in 2020. Ambulatory patient experience is at the 91st percentile nationally at NEMG. The transformation of clinicians and operations in these four years working together to prioritize patients needing care, reaching out to patients, seeing them and completing transitions of care has yielded tremendous results including reducing readmissions and lowering overall cost.