Texas ACO Produces $14M in Savings, Acquires Perfect Quality Score

Rio Grande Valley Health Alliance, LLC (RGVHA), a Texas ACO (accountable care organization) based in the region of McAllen, Texas, is acquiring important cost savings and quality improvements spearheaded by area primary care physicians who’ve joined hands with population health technology provider Lightbeam Health Solutions.

The Texas ACO contains 18 primary care physician practices working with the Centers for Medicare & Medicaid Services (CMS) to give coordinated care to Medicare sufferers in the Rio Grande Valley of South Texas. Since it started operating as an ACO in the year of 2013, RGVHA has saved more than $28 million – almost $14 million in the year of 2015 alone – by better stratifying and serving its population with tools from Lightbeam.

“Lightbeam’s value to our ACO goes beyond population health software because we benefit merely as much from Lightbeam’s information and best practices for orchestrating proactive and efficient work by physicians and care management teams. Lightbeam assists us stay a step ahead of our populations’ health requirements, which lets us deliver both quality and cost savings that we are very proud of,” stated Victoria Farias, assistant administrator at Rio Grande Valley Health Alliance, LLC. “We sustain collaborating with Lightbeam to recognize and deal new ways of cost-effectively providing high-quality care, especially for those patients with the most acute and chronic conditions.”

In the latest ACO Financial Report from CMS profiling results from the 2015 Medicare Shared Savings Program (MSSP), RGVHA was also one of mere four ACOs in the nationwide program to acquire a perfect 100% quality score. These outcomes were because of the ACO working with a scorecard system based on Lightbeam quality measures that also targeted non-compliant patients so care teams could more proactively handle those individuals’ care.

“We are proud to join hands with Rio Grande Valley Health Alliance to find ways to decrease healthcare charges while identifying sufferers whose lives can be improved simply through heightened healthcare education and more proactive care coordination,” claimed Pat Cline, CEO of Lightbeam. “The Lightbeam platform assists ACOs such as Rio Grande risk-stratify their populations to a granular level and our tools deliver that reliable information to care teams that use it to move more rapidly and decisively to close care gaps, increase patient engagement and decrease cost. We consider that Rio Grande is an outstanding blueprint for other ACOs looking to deliver similar savings and quality scores.”

Key points of the victory of RGVHA Texas ACO involve:

• Reducing home health spending by 41%


• Viewing sufferers’ underlying data, comparing it to CMS home health criteria, and recognizing patients who qualify for alternative avenues of care


• Decreasing emergency room visits and associated hospitalizations by 10%


• Improving care coordination across the health system and connecting area providers to better handle several patient populations

A significant next step for the ACO is deploying the Lightbeam Cohort Builder to assist RGVHA further identify high-risk sufferers who can enroll in several evidence-based care programs to make better patient outcomes and lower costs. Cohort analysis assists ACOs and providers by offering clear guidance and prioritizing where care management and other attempts should be focused.