Bundled Payments in Action: How BPCI Advanced helped Phoenix Heart save a life and gain physician buy-in

Phoenix Heart PLLC is a cardiology group with six offices in the greater Phoenix area, performing a wide range of services for its patients, including percutaneous coronary intervention (PCI), which it offers as part of the Bundled Payments for Care Improvement (BPCI) Advanced bundled payment program. 

The group works with Archway to manage its program, using Archway’s technology and value-based care advisory team to manage episodes and analyze performance. 

One of the challenges that Phoenix Heart CEO, Kyle Matthews, faced when introducing the BPCI Advanced program to the group, like many other providers we work with, was getting physicians to buy in. A recent case illustrated how the program not only saves money – it can help improve outcomes, and even save lives.

More than just a financial program

To many, the concept of bundled payment programs is still a new one, and it can be a hard sell. At Phoenix Heart, adding a bundled payment program to the group’s repertoire was a cause for concern among the staff, who could have seen it as another operational protocol that hindered care. 

“I kept saying over and over to the physicians, ‘this is more than just a financial program, this is more than just a pilot program or proof-of-concept, this is something that will improve clinical workflows.’” 

A timely intervention 

To find success in any bundled payment program, a provider must closely track a patient’s journey throughout the entire 90-day episode of care. When the Phoenix Heart staff discovered that a patient who had recently been in for a PCI procedure was no longer in contact, they knew they needed to take action quickly. Using Archway Carelink and other care management tools, the team discovered that the patient had been dispatched by another physician to a rehab facility for a non-cardiac-related issue. Additionally, the patient was not receiving the medication they were supposed to take after their discharge, leading to a potentially life-threatening situation. 

Phoenix Heart physicians immediately arranged for the patient to be put back on the medication and set up an appointment at a Phoenix Heart office for the next day. The patient was “very sick” when they arrived, says Matthews.  

Because the patient's case was part of a bundled payment program, which requires constant and clear communication between all of the providers involved, Phoenix Heart was able to make a timely intervention and put the patient back on the road to recovery. 

“We really credit the bundle for putting the patient back on the right track, especially getting them on the medication they should have been on in the first place, and potentially saving their life.”

Transforming physician engagement

As a result of this case and continued staff education, BPCI Advanced has helped turn Matthews’ colleagues into more engaged bundled care providers. “I think they feel a little more attachment to their patients,” says Matthews. 

“This is coming up early on, and this story is being told in physician meetings...it really brought home the clinical piece of it. It helped my colleagues understand – ‘OK, now we see why this is being done, why there is a focus on these types of things.' I do believe it gives a lot more credence to the program."

With its providers engaged with BPCI Advanced, Matthews can focus on helping Phoenix Heart differentiate itself among other physicians, which he says was a significant factor in Phoenix Heart’s decision to work within the BPCI Advanced framework.The program gave Phoenix Heart the ability to offer quality-based care that would be more attractive to regional and national health plans alike. 

“I think it puts us ahead of the curve when it comes to value-based care,” says Matthews. 

Working with Archway

Phoenix Heart works with Archway to manage its program, using Archway Carelink and Archway Analytics to manage episodes and analyze performance, which Matthews says has been instrumental to the program’s overall success. 

“Before even getting to the data and analytics, just breaking down the historical, seeing the viability of the program, I don’t think we could have even made that decision on our own,” he says. “We needed somebody to kind of help us through that, walk us through what that looked like, the bundles we should focus on…I do not believe we would have any chance of success without Archway.”

To create your own future success story, get in touch with a member of our value-based care team.