Background

Dr. Mary Carol Jennings, MD, MPH, is the Chief Medical Officer of Sendero Health Plans, a local non-profit health plan based in Austin, Texas. Sendero offers individual insurance coverage on the Affordable Care Act’s (ACA) Marketplace and is unique among other payers in the focus it places on ensuring access to affordable, quality healthcare coverage among low-income and previously uninsured residents of its home County. We spoke with Dr. Jennings to learn how her team has been using ARC to better manage population health and deliver a high-value portfolio of services to its members.

Utilization of ARC

Sendero Health Plans works with a broad network of providers and vendors. Dr. Jennings and her team are often challenged to combine diverse sources of data to make evidence-based decisions for their populations. Sendero has been able to leverage Dr. Jennings’ deep experience in population and public health to drive an increased focus on translating data, and its real-time visualization through ARC into proactive population health management policies and programs. The ARC platform provides Dr Jennings and her team with the high-level visuals on key performance metrics they need in order to efficiently identify potential areas of improvement.

Preventable Emergency Department Utilization

One recent example in which ARC has been particularly useful to help Sendero identify population health improvement initiatives, involves the use of the ARC Emergency Department dashboard. As part of its mission to serve low-income members of the community, Sendero administers a no-deductible ACA plan to this population in partnership with the local County Hospital Authority. The plan is working to shift the curve on high-cost and preventable utilization over time, as a function of improved connections to and access to care.

Using the definitions of preventable emergency department utilization that ARC has built into the Emergency Department dashboard, Sendero was able to efficiently assess a key performance metric of their ACA plan partnership. The results show that plan participants had experienced a reduction in preventable use of the emergency department utilization between the first and fourth quarters of 2019. This enables Sendero to both improve performance for its membership and to highlight to the Hospital District the positive outcomes of its work with providers increasing access to and quality of health care services.

ARC ED Dashboard – Demo Data

For more information, please contact info@copehealthsolutions.com.