Advocate Medical Group (AMG), a Chicago-based medical group with more than 200 different practice sites, has a Managed Care Population Program (MCPP) as part of their Accountable Care Organization.
The MCPP handles risk-based financial contracts for the managed care population, and assumes the full financial risk of patient care. The program’s utilization is managed by Lata Patel and Virginia Stasaitis.
Patel and Stasaitis work closely with the physicians in both Advocate Medical Group and Advocate Physician Partners to provide cost effective, quality care to reduce overall medical costs, and maintain continuity of care for patients who are high utilizers of services across various practices.
To ensure that costs are monitored closely and that patients continue to receive the levels of care their Advocate physicians provide, the Managed Care Population Program regularly communicates with other hospitals and healthcare facilities in the area, as well as Advocate physicians, to maintain members’ healthcare needs within the insurance plan’s network.
According to Stasaitis, accountable care organizations, and those working toward value-based care, need to have a mechanism in place to keep managed care population patients in network; not only to reduce medical costs, but to provide more comprehensive continuity of care, which is important for achieving improved outcomes.