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The payment made it possible for practices to fund care management and perform other services that helped patients do a better job of managing their health between doctor visits. Locally, a team of quality improvement professionals at The Health Collaborative led the selected practices in a four-year learning collaborative where doctors and care coordinators shared best practices and participated in coaching. Practices also submitted clinical quality data to track patient outcomes and payers submited billing data to track cost. The data was aggregated to calculate whether patients in these practices had fewer avoidable emergency room episodes, fewer hospitalizations and had better outcomes at a lower cost. Aggregating cost and outcome data is a new process in our market and it has taken some time to develop confidence in the numbers generated for reported savings. We know that for 2014, the cost of serving Medicare patients in our CPC practices resulted in a $6.5 Million dollar gross savings while also increasing patient satisfaction scores. Results for 2015 will be released later this fall. Also notable is that patients in the participating practices, when surveyed about their experience, report a high level of satisfaction with their care providers and with the quality of care they received. We always believed high quality primary care led to better health and lower cost, said Dr. Shelly Stanforth, a physician at Maineville Family Medicine who is participating in the pilot.

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FILE - A local woman reacts next to her destroyed home after shelling in pro-Russian rebels controlled Staromykhaylivka village near of Donetsk, Ukraine. In their contingency planning, Ukrainian military strategists say the heights just south of Kramatorsk and north of Horlivka in the Donbas would likely be another major Russian military objective. Seizing the heights would give Russian-backed forces a strategic vantage point for shelling Ukrainian forces besieging the separatist-held city of Donetsk. The heights also offer command of two important crossroads. There will be diversions and movements, Ukrainian strategists think. If they start with an offensive from Crimea we would be able to hold them back, claims Arestovych. He says Ukraines military is in much better shape than it was last year, thanks to training by Western military advisers from the US, Canada and some other NATO countries. The Russian military and pro-Moscow separatists would start first in the east to try to divert us, says Arestovych. In the Donbas the sides are more or less evenly matched. Ukraine has about 100,000 soldiers now, say officials, deployed along the 500-kilometer contact line in eastern Ukraine, where the warring sides have traded fire for months despite the 2015 Minsk 2 cease-fire agreement brokered by France and Germany. FILE – A local woman reacts next to her destroyed home after shelling in pro-Russian rebels controlled Staromykhaylivka village near of Donetsk, Ukraine. Ukraine military officials estimate there are 45,000 Russian-backed forces consisting of local recruits, former Russian servicemen and current Russian regulars on Ukrainian territory in the east with another 45,000 regular troops stationed just across the international border in the Russian Federation.

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