Program uses data-driven process improvement to strengthen engagement and workflows to close care gaps

CareAllies and General Practice Associates, a family medicine practice located in Philadelphia, announced they received a 2024 KLAS Points of Light award for their work using data-driven process improvement to increase annual screenings for breast cancer, colorectal cancer, and diabetic retinopathy.

Preventive screenings help improve patient health outcomes and lower health care costs, but both payers and providers recognize that it is often challenging to ensure patients receive these highly effective screenings every year.

General Practice Associates collaborated with CareAllies and health benefits provider Cigna Healthcare to use quality and electronic health record data to determine why Medicare patients they serve weren’t getting the necessary screenings. The data revealed that a large percentage of non-compliant patients were not receiving or following through with referrals.

Using this information, CareAllies worked with General Practice Associates to map out the current referral process and develop revised workflows that helped ensure patients who need screenings have the appropriate referrals in place in a timely manner. In addition, they created patient education materials to improve engagement.

“We are consistently seeking ways to improve ourselves for the benefit of our patients and their health needs,” stated Dr. Larry Doroshow, physician champion of the project from General Practice Associates. “Our team has embraced the changes because they were involved in the initiative and ensured any new processes fit logically into our existing workflows. Because of this work, we’ve seen more Medicare patients getting their annual preventive screenings, and we improved our performance for all three Star Rating measures.”

Following the implementation of new processes, General Practice Associates experienced a drastic improvement in patient compliance with preventive screenings, in part due to the increase in referrals. As of 2023, data showed non-compliance due to lack of referral decreased by:

  • 59% in breast cancer screening patients
  • 12% in colorectal cancer screening patients
  • 89% in diabetic retinopathy exam patients

“We know that physicians and their staff are overwhelmed with so many tasks that often pull them away from patient care,” said Dr. Joe Nicholson, chief medical officer for CareAllies. “By utilizing data, and working together, we can uncover opportunities to improve processes and the patient experience. We are thrilled that this partnership received a KLAS Points of Light award, and that General Practice Associates is getting recognition for their culture of continuous improvement.”

KLAS’ Points of Light Award recognizes payers, health care organizations, and vendors who have demonstrated a close collaboration that leads to improved processes and outcomes. The complete case study about how CareAllies, General Practice Associates, and Cigna Healthcare partnered can be accessed here.

About CareAllies

Ranked the number one value-based care solution for physician organizations from 2018-2024 by Black Book Market Research, CareAllies has over 20 years of experience in providing business advisory and management services that physician organizations need to succeed in value-based care. CareAllies, a subsidiary of The Cigna Group, simplifies the journey to more rewarding health care by providing the people, processes and technology needed to reduce administrative burden, empower physicians, and promote financial success. CareAllies aggregates and analyzes data, delivers actionable reports and decision-support tools within existing workflows, and deploys business and clinical support teams to enhance operations, align incentives, and improve care coordination. Collaborating with CareAllies helps physicians deliver more accessible and affordable care while allowing them to focus on their most rewarding endeavor: improving patient health outcomes. To learn more about CareAllies, including links to follow them on Facebook, LinkedIn or YouTube, visit www.careallies.com.

About General Practice Associates

General Practice Associates is a physician practice located in Philadelphia, Pennsylvania. It is part of the Constitution Physician Alliance IPA — a group of physician practices located in the greater Philadelphia area that work together and share resources to deliver the highest quality care experience for patients. The group was formed under the uniting mission that care should be provided in a localized area that is convenient and cost-efficient for patients. Constitution Physician Alliance is managed by CareAllies and emphasizes preventive care, data sharing and population health management.

Megan Smith msmith@mergeworld.com 404-408-3379