Audacious Inquiry’s Encounter Notification Service® (ENS®) helps Angel Kids Pediatrics improve both Pediatric Clinical Quality Measures (CQMs) and HEDIS measures while reducing hospital utilization and total cost of care.
Background and the Need
Angel Kids Pediatrics is a rapidly growing practice in northeast Florida, expanding from two to seven offices between 2014 to 2019. Supporting direct patient care, Angel Kids provides integrated services including behavioral health, chronic disease management, and in-house allergy testing. As a patient-centered medical home (PCMH), quality of care is continually measured and monitored for their 25,000 plus patients in Duval and, St. Johns counties to ensure the best care possible.
Angel Kids Pediatrics initially received ENS alerts for their patients through one of Florida’s Medicaid Managed Care plans. The benefit of having the data to improve care and lower costs for all their patients was quickly recognized and they began a direct subscription to receive data for all of their patients. This data was incorporated into the practice’s quality approach.
ENS helped in identifying unnecessary emergency department visits, providing information needed for direct patient engagement, and education on appropriate service use. Daily ENS reporting is also used for patient hospitalization follow-up and education, ensuring appropriate care management after treatment. Patient outreach made possible by ENS has resulted in a significant decrease in preventable emergency department visits.
“The use of technology and data is critical for physicians to adopt as we continue to move toward value-based care. Having patient information is very important as we move to value-based care. Practices can use ENS data to improve patient engagement for care coordination and education on proper health care
facility utilization.” – Ashraf Affan, MD | Founder and CEO of Angel Kids Pediatrics
ENS helps Angel Kids Pediatrics track and manage a core set of 10 targeted metrics aligned with the Pediatric Clinical Quality Measures (CQMs) and HEDIS. The use of data received through ENS assisted Angel Kids in exceeding the benchmark for 9 out of the 10 targets. Between 2016 and 2017, Angel Kids Pediatrics experienced a 71% reduction in inpatient admissions per month, and cost savings of $5 PMPM (33% reduction) due to decreased Emergency Department utilization.
In 2016, their overall per member per month was $204.21, 29% less expensive than their peers. The key strategies that contributed to this include focusing on preventative care, prioritizing chronic disease management, and ensuring appropriate use of healthcare resources such as emergency room use and generic medications. These strategies are supported through data received from the Florida HIE’s ENS.
Angel Kids Pediatrics, recognizing that patients’ health care experience is not limited to the doctor’s office during regular business hours, implemented strategies to extend reach and increase access for patients. ENS is an integral part of overall efforts to increase access and provide proactive outreach to their patients. ENS provides the information needed for care transition services for patients who are discharged from the hospital and for those who use the emergency department unnecessarily.
The information available via ENS supports Angel Kids Pediatrics core strategies that allow them to provide high-quality care, demonstrated by exceeding the benchmarks in 9 out of 10 targeted measures. This quality care has resulted in decreased utilization, reducing admissions from 51 per month to 14 per month, and cost savings to payers. Through savings earned from value-based agreements, Angel Kids Pediatrics is able to sustain quality results and reinvest in new strategies that are most impactful to their practice and
Angel Kid Pediatrics
At Angel Kids Pediatrics, we strive to provide excellent medical care in a family and community-based environment. We uphold the highest standards of a patient-centered medical home that provides quality, personalized and effective medical care.
Learn More at myangelkids.com
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