Market Overview

As CMS Pushes ACOs to Take on More Risk for MSSP, Turn-Key Health Points to Home-Based Palliative Care as a Value-Based Strategy


(TKH), an affiliate of Enclara Healthcare, serving health
plans, provider organizations and their members who are experiencing a
serious or advanced illness, advises accountable care organizations
(ACOs) to introduce home-based palliative care as a strategy for
achieving success in the Medicare Shared Savings Program (MSSP).
Turn-Key's community-based palliative care model, which can be rapidly
deployed in any geographic area and scaled for larger populations,
is designed to meet the needs of seriously ill individuals and their
families outside of the hospital setting. This enables ACOs to
quickly introduce options that are proven to lower costs and improve
patient outcomes, with enhanced quality of life for individuals and
their caregivers.

Randall Krakauer, M.D., member of the Advisory Board to TKH,
says, "Populations of people who have a serious or advanced illness
place incredible strain on ACO resources, compromising their ability to
improve care while generating shared savings under the MSSP model. By
adopting a newer approach, such as Turn-Key's Palliative Illness
Management program, ACOs can turn this high cost population into an
opportunity, improving quality and patient satisfaction while reducing
cost and generating shared savings through reduced unnecessary
admissions, readmissions, ICU stays and other such services that are not
helpful in such situations. This type of innovation will be a necessary
condition for ACOs to operate successfully under the newly proposed risk

The proposed
 issued by the Center for Medicare & Medicaid Services (CMS)
shrinks the amount of time ACOs can be in an upside-only model to two
years. Currently, 82 percent of ACOs participating in the MSSP are in an
upside-only model.

Dr. Krakauer adds, "A systematic approach to community-based palliative
care delivery can effectively manage the most vulnerable and costliest
member populations. This strategy enables ACOs to improve patient
quality of care and experience, decrease caregiver burden, and lower the
total cost of care. Given the new CMS requirements around risk sharing,
ACOs should programmatically focus on the extraordinary healthcare needs
within the growing senior and baby boomer population. Programs such as
this represent the greatest opportunity for effective impact at the
intersection of quality and cost."

Greer Myers, president, Turn-Key, points to this specialized care as an
extension of medical practices within the ACO, adding, "Our
community-based palliative care network team members act as an extension
of the primary treating physician, and strengthen the medical home. The
palliative nurses and social workers establish goals of care, provide
supportive home-based care and assess patient and caregiver status,
reporting relevant information to the primary treating physician to fill
gaps in care and better align goals with care received."

About Turn-Key Health
, a subsidiary of Enclara Healthcare,
serves health plans, provider organizations and their members who are
experiencing a serious or advanced illness. Its Palliative Illness
Management™ (PIM™) model introduces a new, innovative option to improve
care quality, address costs and reduce burdens associated with
life-limiting illnesses. Visit

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