eBrightHealth ACO Waiver Protection Form
Program Name:
Care Coordination and Population Health Data Analytics and Informatics
Type of Waiver Utilized:
ACO Participation Waiver
All Parties Involved:
All ACO Practice Participants
Christiana Care Health Services, Inc.
Christiana Care Quality Partners ACO, LLC d/b/a eBrightHealth ACO
Christiana Care Care Link, LLC d/b/a CareVio
Date Program will begin:
January 1, 2016 (revised effective January 1, 2022)
Description of Arrangement:
Christiana Care Health Services, Inc. (CCHS) is the parent company to Christiana Care Quality Partners ACO, LLC d/b/a eBrightHealth ACO and Christiana Care Care Link, LLC d/b/a CareVio.
eBrightHealth ACO has an agreement with CareVio to provide Care Coordination services for ACO Participants.
CareVio employs an interdisciplinary care coordination team comprised of Case Managers, Care Connectors, Social Workers, Respiratory Care Practitioners, Pharmacists and Support Staff, working under the direction of one or more Medical Directors.
eBrightHealth ACO Participants are expected to utilize CareVio to the fullest extent deemed reasonably necessary by the ACO in order to further the purposes of the Medicare Shared Savings Program (MSSP). They contribute to this goal by:
- Care coordination and care transition resources for high-risk and chronic condition populations
- Assist patients to address social, behavioral, transportation and financial assistance needs
- Link the patient with local and regional community resources
- Teaching, counseling, monitoring and direct care intervention pursuant to medical regimens ordered by ACO participating providers
- The use of comprehensive analytics to identify patient needs and trend practice performance
CCHS has invested in Population Health software to support population health data, analytics and informatics needed for ACO operations and CareVio’s Care Coordination services. eBrightHealth ACO charges ACO Participants an ACO Administration fee to cover some of the operational expenses of the ACO. CCHS finances the majority of expenses associated with eBrightHealth ACO operational expenses and expenses related to CareVio Care Coordination and related population health data, analytics and informatics.
Purpose of Arrangement:
The purpose of this arrangement is to coordinate and facilitate care across various health care providers in support of the Medicare Shared Savings Program to provide better care for individuals, better health for populations and lowering growth in healthcare expenditures.
Items, services, facilities or goods covered by the arrangement:
Care Coordination services as outlined above while utilizing the Population Health software to provide the data, analytics and informatics needed for ACO Administration and Care Coordination services.
Date and manner of the Governing Body’s Authorization:
Approved by the Board of Managers on 7/29/2015. Revised waiver approved by Board of Managers on 9/16/2021.