MetroHealth Innovation Leads to CMS Direct Contracting Entity
Cleveland - The MetroHealth System is implementing a new initiative for Medicare patients that recognizes MetroHealth’s experience in providing high-quality, cost-effective care.
The Centers for Medicare and Medicaid (CMS) recently awarded MetroHealth approval to operate a Direct Contracting Entity, a cutting-edge value-based care model. Implementation is underway now and full operations start April 1, 2021, as Collaborative Care Partners, in which all MetroHealth providers participate.
A CMS Direct Contracting Entity (DCE) is a group of physicians, hospitals and other providers along the health care continuum working together to deliver high-quality coordinated care while helping slow the growth of health care costs. For example, providers work as a team to use information, communications and care settings in more sophisticated ways to assess and address factors that affect patients’ overall health as well as improve wellness activities. MetroHealth applies its innovative care delivery approaches to serve patients who have Medicare fee-for-service coverage as part of its Direct Contracting Entity participation.
“The MetroHealth System is building upon its Medicare Shared Savings Program Accountable Care Organization successes 2014 through current. We are proud to implement the latest evolution of value-based care models both from CMS and with our managed care payers,” said Susan Mego, Collaborative Care Partners President and MetroHealth’s Executive Director of Payer Strategy, Managed Care and Operations.
MetroHealth operates numerous value-based initiatives designed to meet four goals; producing better care for individuals; better health for populations; lower total cost of care, and better care team well-being.
Collaborative Care Partners is another of those initiatives and the type for which the health system utilizes the most advanced risk-bearing payment method.
“This is an exciting occasion giving MetroHealth an even better opportunity to be rewarded when it improves health care while reducing Medicare spending. It directly aligns with how our clinical teams work hand in hand with our Population Health Innovation Institute,” said Dr. Nabil Chehade, Chair of the Collaborative Care Partners Governing Board and MetroHealth’s Executive Vice President and Chief Clinical Transformation Officer.
The MetroHealth System is redefining health care by going beyond medical treatment to improve the foundations of community health and well-being: affordable housing, a cleaner environment, economic opportunity and access to fresh food, convenient transportation, legal help and other services. The system strives to become as good at preventing disease as it is at treating it.
The system’s more than 600 doctors, 1,700 nurses and 7,800 employees go to work each day with a mission of service, to their patients and to the community. As Cuyahoga County’s safety-net health system, MetroHealth plays an essential role in the region, caring for anyone and everyone, regardless of an ability to pay.
Founded in 1837, MetroHealth operates four hospitals, four emergency departments and more than 20 health centers and 40 additional sites throughout Cuyahoga County. The system serves more than 300,000 patients, two-thirds of whom are uninsured or covered by Medicare or Medicaid.
MetroHealth is home to Cuyahoga County’s most experienced Level I Adult Trauma Center, verified since 1992, and Ohio’s only adult and pediatric trauma and burn center.
As an academic medical center, MetroHealth is committed to research and to teaching and training tomorrow’s caregivers. Each active staff physician holds a faculty appointment at Case Western Reserve University School of Medicine. Its main campus hospital houses the Cleveland Metropolitan School District’s Lincoln-West School of Science & Health, the only high school in America located inside a hospital.
Knowing that good health is about much more than good medical care, MetroHealth has launched the Institute for H.O.P.E.™ (Health, Opportunity, Partnership, Empowerment), which uses a coordinated, collaborative and strategic approach to help patients with non-medical needs such as healthy food, stable housing and job training.
The MetroHealth Glick Center, a new 11-floor hospital, is under construction on the system’s main campus in Cleveland and is scheduled to welcome its first patients in October 2022. The billion-dollar project is the cornerstone of a wider neighborhood revitalization effort led by the system and its partners in the community.
For more information, visit metrohealth.org.