By Brenda Flanagan
True story: It’s Christmas Eve. Suddenly an elderly diabetic’s family notices his speech getting slurred. They almost dial 9-1-1 to call an ambulance.
“The daughter — appropriately — was concerned the patient might be having a stroke,” said Dr. Morey Menacker.
Dr. Menacker heads a new Medicare practice with Hackensack University Medical Center, where the diabetic’s a patient. His family called the nurse there.
“She said, ‘Let me get one of the doctors to stay late. Come to the office.’ The patient came in, had very low blood sugar, was given some orange juice. The slurred speech resolved. His medications were adjusted,” said Menacker.
He says everybody goes home, happy and celebrates the holiday. But Menacker says there’s even more to celebrate.
“The system was saved anywhere from $10,000 to $15,000 for an emergency room visit to $100,000 for a hospitalization for a possible stroke,” he said.
One hundred doctors at HackensackUMC participate in this Medicare practice, called an ACO — Accountable Care Organization. It’s part of a much larger, national program launched by Medicare two years ago. Its ambition: to improve patient care, while saving money. As an incentive for meeting its goals, Medicare offered each ACO a special bonus.
“We were able to receive 50 percent of the savings and distribute that back to the physicians who were providing the care,” said Menacker.
Not every ACO met its goals. Out of 11 in New Jersey, only three hit the mark and earned a bonus: Hackensack, more than $10 million in savings, more than a $5 million bonus; Meridian in Neptune with almost $15 million in savings, earned more than $7 million back. Optimus saved more than $17 million. The bonus? More than $8 million. ACOs saved over $370,000 nationwide.
“Half of the money came back to the organization and the physicians will be able to share in excess of $2 million,” said Menacker.
He says they earn it. Doctors work longer hours, special nurses help patients navigate the Medicare system, patients get intense followup and preventive care. It’s a paradigm shift from how hospitals use to discharge patients.
“And everybody would kiss ’em goodbye and forget about them. Well now, you need to be responsible for that patient,” said Menacker.
Here at Hackensack, they want to expand their program — double the number of doctors who’ll also get the chance to offer comprehensive care — and earn a bonus in the process.