Program increased visibility into patient whereabouts to improve Medicare Advantage patient outcomes and CMS Star Ratings
Louisville, KY & Boston — May 16, 2024 — Lack of real-time data can present serious barriers to care coordination for patients after they leave the hospital. That challenge was the motivation for an innovative collaboration between Bamboo Health™, the leader in Real-Time Care Intelligence™, Humana and Privia Medical Group (PMG)–Georgia to bridge care gaps for patients enrolled in Medicare Advantage plans. The program was one of only 22 presentations selected for a Points of Light Award on May 14 at the 2024 K2 Collaborative Summit, a KLAS Research conference for health plans, providers and industry leaders.
“At Humana, we are dedicated to delivering personalized, high-quality care experiences for our members,” said John Cope, Director of Stars Technology at Humana. “Partnering with Bamboo Health and Privia in Georgia has enabled us to leverage cutting-edge technology to optimize care coordination and support our members’ healthcare journeys. This recognition reaffirms our commitment to driving innovation and fostering collaborative partnerships that positively impact patient outcomes and advance the future of healthcare.”
The collaboration, launched in Georgia, illustrates the value of health plans and provider organizations working together to achieve shared value-based care outcomes. Bamboo Health’s care coordination solutions, including Pings and Care Gaps, provided real-time notification flags for Transitions of Care (TRC) and post-ED follow-up for patients with high-risk multiple chronic conditions (FMC). This visibility allowed Humana’s health plan and Privia’s patient care teams to coordinate and monitor care from admission to discharge to post-acute and follow-up care. The proof-of-concept worked to avoid any gaps in care as patients pivoted from inpatient to follow-up settings within a 72-hour window.
By working together, the collaborative team was able to improve patient outcomes, reduce the risk of hospital readmissions, lower cost of care and better CMS Star Ratings. The results of the program included:
- Increased visibility into patient whereabouts via Bamboo Health’s Pings platforms’ TRC & FMC flags over a 90-day period
- 8.2 percent improvement in TRC measures by Privia
- 3.2 percent improvement in FMC measures by Privia
- 84 percent of Pings alerts closed by Privia, resulting in timelier follow-up, better care coordination for patients/members, and improved provider satisfaction
“We are honored to be recognized alongside Bamboo Health and Humana for our collective efforts in driving innovation and improving patient care,” said Ryan Graham, Vice President of Practice Operations and Value-based Care at PMG–Georgia. “This collaboration exemplifies the power of technology-enabled solutions in bridging care gaps and enhancing care coordination. Through real-time insights and proactive interventions, we are improving health outcomes for our patients and strengthening the healthcare ecosystem as a whole.”
The project demonstrated that using technology to create strong governance structures and streamlined communication networks among all stakeholders is essential in improving alignment between health plans and care teams. Bamboo Health and Humana are currently assessing opportunities to add additional electronic health records (EHR) integrations and plan to expand the program to other provider organizations and markets across the country.
For more information about how stakeholder collaboration can improve care transitions and patient outcomes, visit bamboohealth.com/closecaregaps.
About Humana Inc.
Humana Inc. is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell health care services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
About Privia Medical Group—Georgia
Privia Medical Group—Georgia is part of Privia Health, a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings. The Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. For more information, visit priviahealth.com.
About Bamboo Health
Bamboo Health, the leader in Real-Time Care Intelligence™, delivers actionable insights on a patient’s physical, behavioral and social health – empowering healthcare professionals to provide the right care at the right time for the right outcomes. Delivered through our Smart Signals™ network – the largest and most interoperable care collaboration community in the nation – our insights improve more than 1 billion patient encounters a year across more than 2,500 hospitals, 8,000 post-acute facilities, 25,000 pharmacies, 32 health plans, 50 state governments and 1 million acute and ambulatory providers. Connect with Bamboo Health on Twitter, LinkedIn and Facebook. Visit BambooHealth.com to learn more.
