Clinicians who embark on a career in primary care sign on to play many roles — diagnostician, confidant, care team coordinator, prescriber of therapies, provider of education, performer of in-office procedures and more.

Unfortunately, these physicians often have their days filled up and their spirits tested by other roles they never sought: data analyst, accountant and small business owner managing cash flow, all while waiting for quality-care payments owed for services provided months or even years earlier.

Created to avoid such situations, Hoboken-based Vytalize Health is a physician-founded accountable care organization (ACO) that allows primary care providers to focus on and flourish in the roles they chose — which enhances their patients’ physical health, their own emotional health and their practices’ financial health.

“When physicians and advanced practice providers are freed up to do what they do best — take care of patients — good things happen,” said Internist Amer Alnajar, MD, who co-founded Vytalize Health with Faris Ghawi, MBA. “When those clinicians’ efforts are supported by a team providing virtual care, in-home care, care coordination and data analysis, such as we do at Vytalize Health — good clinical outcomes are accompanied by strong financial performance.

“As physicians, we all strive to practice evidence-based medicine. We should bring the same data-driven mindset to managing our practices. That is the approach we took when we started Vytalize Health in 2014, and it has enabled us to develop a care delivery model that has transformed the health care experience for more than 250,000 Medicare beneficiaries across 36 states,” Dr. Alnajar added. “Just as importantly, and very much by design, our approach has transformed the health care-provision experience for those patients’ 3,000-plus providers.”

The physician pointed out that practices that have engaged with Vytalize Health have achieved a 41% reduction in emergency department (ED) utilization, 38% reduction in hospital admissions, 17% increase in patient retention and 9% cost savings, which are shared with clinicians.

This New Jersey-based ACO enhances patient health, clinician well-being and practice finances in five important ways.

Receiving shared-savings payments now, not later

“Just as physicians do at a new patient’s first visit, when we began developing our ACO, we conducted a comprehensive evaluation to identify various issues that needed to be addressed. And in talking with providers, we heard a host of complaints, from the burdens that a siloed health system places on the individual practitioner trying to provide comprehensive care to the desire to maintain independence in a rapidly consolidating health care environment,” said Ghawi, who worked as an international business consultant before co-founding Vytalize with Dr. Alnajar. “But another major problem that came up time and again was how long physicians had to wait to receive payments for providing value-based care. The clinician had provided excellent care, and the patient had benefited, but months went by before the accountable care organization, integrated delivery network, or other entity shared the resultant cost savings with the clinician. We determined from the outset that we were going to be different.”

Vytalize Health does not achieve and share such savings by limiting care: Vytalize patients see their primary care provider 78% more than the average Medicare beneficiary — and providers have three times more time to spend with each patient compared to national norms for office encounters. This enables more effective management of chronic conditions and prompt identification and treatment of any new health issues, which ultimately decreases costs, Dr. Alnajar explained.

“With Vytalize, the primary care provider retains his or her independence and remains the point person for the patient’s care, but we support that clinician with a wide array of services to enhance care,” the internist noted, explaining that those services include:

• Virtual and in-home clinics to support patient care between office visits.
• Identification of care gaps and actionable insights by analyzing clinical notes, claims, social determinants of health data, and hospital feeds.
• Integration with high-performing systems of care, including hospitals, specialists and ancillary care providers for end-to-end care management.

“In 2018, we took our successful clinical model and paired it with a very effective business model. This enables us to share the cost savings we generate for Medicare with our physician partners,” Ghawi said. “In addition, we continued to enhance the clinical model, so that today our multidisciplinary clinical team serves as an extension of each physician to design custom-tailored care plans for each of their Medicare patients that are proven to prevent and reduce hospitalizations and improve quality of life.”

5 benefits of joining an ACO — and choosing Vytalize Health

“There are five main reasons for primary care providers to join an ACO,” Dr. Alnajar said. “I’m proud to say that in each of those areas, Vytalize Health meets providers’ needs in a way that exceeds what other accountable care organizations can offer them.”

Those reasons — and the Vytalize differentiator for each — are to:

1. Improve patient outcomes. “The 41% reduction in ED utilization and 38% reduction in hospital admissions that we’ve achieved are just two of many indices of the enhanced outcomes Vytalize Health clinicians are able to achieve by drawing on the support and data we provide,” Dr. Alnajar noted.
2. Increase revenue and reduce costs. “Unlike the old fee-for-service model, clinicians today earn revenue by providing value-based care that meets patients’ needs while avoiding unnecessary steps and costs. In this model, revenues increase when wasteful spending is avoided,” the physician added.
3. Maintain independence. “Partnering with an ACO offers many advantages over selling your practice to a hospital or being employed by an integrated delivery network,” the internist said. “At Vytalize Health, we recognize that this is a top priority for many physicians, and we structure our working relationships to respect practitioner autonomy.”
4. Access cutting-edge resources. “Our data analytics are a powerful tool for clinical decision-making and help drive optimal outcomes,” the Vytalize co-founder explained.
5. Benefit from increased collaboration. “By providing virtual and even in-home care, when necessary, and by connecting primary care providers with high-performing specialists and ancillary care providers, we enable primary care providers to give their patients comprehensive care while protecting those physicians from excessive hours and burnout,” Dr. Alnajar added.

“It’s been a great addition to our system. It helps me monitor patients, what they need, what they have, what to look for. It also keeps us on track and making sure we’re doing everything that we need to do, allowing the patient to have the best quality of care possible. Vytalize improves our system tenfold.”

— Dr. Ruben De Los Santos

Time for a chat?

“In medicine, as in life, asking the right questions is key to getting the right answers and making the best decisions,” Dr. Alnajar said. “I would urge my colleagues who are interested in learning more about Vytalize Health and the benefits it offers their patients and practices to schedule a 15-minute confidential call with our team.”

Primary care providers seeking to arrange a call with Vytalize Health can do so by visiting info.vytalizehealth.com/our-program.

“The Centers for Medicare and Medicaid Services recently set a goal of having all traditional Medicare beneficiaries participate in an ACO by 2030,” Ghawi noted. “Now is the time to get out in front of that trend by partnering with an organization that respects your autonomy, enables you to focus on patient care, provides the support you need and lets you share in the cost savings that you generate now — not later.”

Vytalize Health – By the Numbers:

What makes Vytalize Health different from other ACOs

Vytalize enables primary care providers to do what they do best — treat patients — and gives them the time and resources they need to treat their patients in a way that closes care gaps and enhances outcomes. The table below details how Vytalize’s division of responsibilities differs from that of other ACOs — to the benefit of both patients and clinicians.

Learn more about Vytalize Health: Visit info.vytalizehealth.com/our-program.