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How one provider is using Medicare Advantage to improve population health

Physicians will coordinate care across primary care, specialists, hospitals, laboratories and other services necessary improve the health of members.

Jeff Lagasse, Associate Editor

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Columbus-based Central Ohio Primary Care, the largest physician-owned independent primary care medical group in the U.S., has entered into an agreement with local and national Medicare Advantage plans through COPC Senior Care Advantage, a new population health management program designed to improve the quality, value, efficiency and outcomes of Medicare Advantage patients.

COPC Senior Care Advantage will roll up its sleeves and focus on Medicare Advantage patients beginning in January of 2018, thanks to new population-health based contracts with a variety of plans.

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The approach reflects the shift to more value-based care, a clinical and care delivery philosophy that has been slowly supplanting the old fee-for-service framework. In a statement, William Wulf, MD, chief executive officer of Central Ohio Primary Care Physicians, called the new model "coordinated care on steroids."

By partnering with like-minded Medicare health plans, COPC Senior Care Advantage will be accountable for improving the health care of its Medicare Advantage patients. Under this model, the physicians at COPC will coordinate all of the care for enrolled members, including primary care, specialists, major local health systems and hospitals, laboratories and all of the ancillary services necessary to improve the health status of those members.

[Also: Population health is in a major state of change]

They will also engage in advanced data analytics to support clinical decisions, with the goal of delivering the appropriate care at the right time and place.

"We believe that more efficient care is possible if physicians assume both clinical and financial responsibility for patient care," said Ben Shaker, president of COPC Senior Care Advantage, in a statement. "By having robust data and increased resources at their fingertips, COPC physicians will be better able to deploy highly integrated, prevention-oriented care.  Better outcomes are possible when innovative clinical programs are supported by actionable and timely data."

The goal is to offer better quality care and save money by providing the right level of care at the right time with a focus on prevention -- with the philosophy that If patients are healthier, they are less likely to need expensive hospitalization or emergency care.

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