How Home Health Has Been Crucial to a Top ACO

The largest accountable care organization (ACO) in New England is a big believer in the home heath value proposition.

Atrius Health, a nonprofit ACO with more than 720,000 adult and pediatric patents, works in tandem with VNA Care, one of the nation’s oldest home health care pagencies, tot produce better outcomes for patients and lower costs.

Atrius Health is one of the original Pioneer ACOs, in existence since 2012. In 2016, the ACO achieved major cost savings—$10.4 million for the Centers for Medicare & Medicaid Services (CMS), with $6.8 million in shared savings returning to the ACO. Among Massachusetts Pioneer ACOs, Atrius Health’s cost of care was the lowest.


Part of its success has been the heavy influence and quality care from its home health care subsidiary, VNA Care—New England’s largest home health, hospice and palliative care providers, serving more than 200 communities.

“Why would a physician group come together with VNA?” Atrius CEO and President Steven Strongwater said Thursday at the National Leadership Conference in Washington, D.C., held by home health provider associations ElevatingHome, the Alliance for Home Health Quality and Innovation, and the Visiting Nurses Associations of America (VNAA). “We are the yin and yang for caring for patients and families. The solution for health care in the United States is to have a better system for care—we need tighter handoffs and better protocols.”

The partnership is also indicative of what is going on around the general health care system—as more providers bad together in mergers and acquisitions.


“The health care transformation is on fire and unstoppable,” Strongwater said.

Strongwater pointed to technology innovations and major funding pouring into the health care space. Not to mention, major players are making crossover deals. Health care giant Aetna (NYSE: AET) is acquiring CVS Health (NYSE: CVS), insurance company Humana (NYSE: HUM) is taking a stake in Kindred at Home (NYSE: KND), and Amazon (Nasdaq: AMZN) has teamed up with JP Morgan and Berkshire Hathaway to make a run at the insurance space. Most recently, health insurance provider Cigna (NYSE: CI) announced it was acquiring pharmacy benefits manager Express Scripts for $52 billion.

Home health results

Of course, VNA Care wouldn’t be playing as big of a role in the ACO if it weren’t producing some stellar results that are leading the organization to its killer cost savings.

VNA Care has solidified its value by taking on population health and delivering pre-acute care, total management, behavioral health, and hospice. Overall, VNA Care has been able to achieve lower hospitalization rates than its peers.

When coupled with telehealth, home health care has been able to cut Atrius Health’s readmission rate to 3.36% for 30-days post discharge, for 157 patients who were on service through the third quarter of 2017. The total savings for Atrius topped $1 million.

VNA Care also saved Atrius $1.662 million in 2017 by helping steer patients out of skilled nursing facilities (SNFs), with a 12% reduction in SNF patients, for 1,168 patients.

Patients enrolled in hospice and palliative care saved Atrius $594,000 in 2017, with lower hospitalization rates.

VNA Care has achieved these results largely by taking a population health approach, which Atrius executes on a basis of diagnosis. Care coordination, with integrated protocols with immediate access to clinicians, and a commitment to the long-term partnership between Atrius and VNA Care has cemented the results. In addition, Atrius Health is looking for financial opportunities in new lines of business, including telehealth and hospital at home programs.

The result is a symbiotic relationship, according to Strongwater.

Written by Amy Baxter

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