Imagine saving $680,000 in 30 days by avoiding 800 unnecessary ER visits

That’s what Lone Star Circle of Care (Lone Star), a NextGen Healthcare client since 2008, has demonstrated with its innovative Health Optimization Solutions Center.

Lone Star is not only the fastest-growing community health center in Texas, but in the country, with 30-plus large ambulatory clinics offering a variety of services.  Spanning five counties in central Texas, Lone Star‘s multi-specialty health system provides family practice, pediatrics, OB/GYN, integrated behavioral health, optometry, dental services, senior care, pharmacy, health & wellness education programs, and Member Optimization. After implementing the NextGen® solution, Lone Star launched the first wave of its innovative Health Optimization Solutions Center. Denise Esper, Chief Revenue Officer of Lone Star, talks about how Lone Star is integrating high-tech, high-touch collaborative care, while improving health and financial outcomes.

A collaborative care model for the country

“That was the turning point; when we really grasped the power of integrating real-time patient data with what our patients were saying, combined with the healthcare needs across our community,”

A single patient record with aggregated health information

“Covering a vast region across central Texas and open seven days a week, we are completely accessible to our patients. Patients can contact us any time and we have immediate access to all their health information contained in their electronic health record.” Aggregated through the HIE from multiple disparate sources, every aspect of their healthcare information, including lab results, medication history, vitals, hospital records, primary care, and specialty care is provided.  “The key is we’re able to proactively respond and assist patients with whatever they might need at the time, while improving outcomes and reducing cost. Supported by NextGen and Mirth technology, we can ensure that we have everything at our fingertips to fully assist those patients in real time.”

Value-based care pays off

“Our process enables the care team to respond immediately to an urgent call from a patient and assign the patient to the emergent nurse queue, where the patient’s condition is assessed. That way, visits to the ED are significantly reduced.  In fact, we were able to divert roughly 800 potential ED visits within 30 days. If you average a conservative $1,000 per ED visit and replace with a Patient Centered Medical Home Primary Care Physician visit, we were able to save approximately $680,000 in one month alone. This is a huge savings, and this is exactly the type of outcome that payers are looking for¾ both public and commercial payers.  In essence, we are creating a longitudinal member record that allows us to feel confident entering into shared risk/savings models with various payers.   Not only are we seeing positive financial results but significantly improved patient outcomes without compromising care quality. This is truly the collaborative care model that is at the heart of the Accountable Care Act.”

To learn more about Lone Star’s Collaborative Care success, read the case study.