MUSC Health Selects UpStream Healthcare as its Value-Based Partner for Medicare Patients

The Medical University of South Carolina (MUSC Health) and national value-based healthcare company, UpStream Healthcare, have jointly announced their partnership to advance the health and well-being of Medicare patients within their expanding network across the state. UpStream is a participant in the CMS innovation center model known as ACO REACH, an advanced alternate payment model (APM) for physicians in value-based arrangements that requires assuming financial risk for Medicare beneficiaries while committing to advancing health equity, stakeholder feedback and participant experience. Over 300 primary care physicians caring for more than 30,000 seniors are expected to participate in the value-based model.

The UpStream and MUSC Health partnership aims to improve quality results for Medicare patients across South Carolina by giving them access to a team committed to improving coordination of care. A goal of the program is to advance health equity for the underserved with a focus on preventive care and managing chronic conditions. The UpStream platform recognizes that primary care physicians have the ability to serve as quarterbacks for their health care system with a unique, proven model known to deliver better outcomes. Pharmacist-led teams are embedded into primary care providers’ practices along with nurse coordinators who perform home visits to coordinate care and ensure patients’ needs are met. UpStream has enabled best-in-class technology to support the sophisticated workflows of this care coordination model.

“UpStream will enhance our physicians’ capabilities to provide better care for our patients, especially for vulnerable seniors in underserved communities who will benefit from this level of coordination,” said Patrick J. Cawley, M.D., MUSC Health CEO. “And, importantly, our collective success is closely tied to producing good patient outcomes and reducing avoidable hospital readmissions, which is a win-win for patients, providers and health systems.”

UpStream CEO, Dr Sanjay Doddamani applauded the partnership, adding, “This transformative approach to senior care will put the patient at the center of the delivery system by leveraging the strength and reciprocal skill sets of both UpStream & MUSC Health to accelerate access to quality care.”

UpStream’s Chief Network Officer, Dr Angelo Sinopoli, executive physician leader and member of the Federal Government’s Physician-Focused Payment Model Technical Advisory Committee (PTAC), said, “Our partnership with MUSC, the state’s only comprehensive academic health system, is an important milestone as we work closely to better align and empower physicians to provide more value-based care. We look forward to working with MUSC Health and we are confident this will further our shared goals of leading health care through innovative clinical, technological, and fee-for-value payment methods that are at the forefront of the industry’s future.”

The synergy from this partnership will create opportunities for providers to improve key metrics and improve clinical outcomes for patients, while strengthening the coordination of primary and specialty care within the network.