The Affordable Care Act has incentivized providers to cut costs, and improve clinical outcomes and patient experience by structuring Accountable Care Organizations ("ACO").  Patients with multiple chronic conditions ("MCC) represent 5 percent of the hospitals' patients, but utilize 50 percent of resources.  Ascendant has identified the “extensivist clinic” model as a way to lower the cost in an ACO by admitting multiple chronic conditions that are now being admitted to acute care hospitals, instead to an outpatient extensivist clinic, so that conditions can be stabilized without requiring hospital beds and overnight stay.  Ascendant has identified the following areas of opportunities:

Extensivist Clinics

Ascendant wishes to form a joint venture with hospital systems, HMOS and/or physicians practices for the development of Extensivist Clinics in high density urban areas. The Extensivist Clinics will provide sub-acute care to MCC patients who would prefer to be treated and stabilized in outpatient clinics rather than in an acute care hospital.  Extensivist Clinics will receive referrals from hospitals following MCC patients being discharged.  The patients will be stabilized in the Extensivist Clinics prior to being discharged to their homes.  Extensivist Clinics will also receive referrals from physician practices and SNF’s, so that patients will be stabilized in the Extensivist Clinics rather than admitted to a hospital.

Multi-specialty Physician Groups

Ascendant wishes to invest in physican groups that wish to remain independent while adapting to the capitated reimbursement system  Capital would be used to restructure the physician practice from a fee for service model to a capitated arrangement to enable the formation of ACO’s.

Physician practices, multi-specialty clinics and PHO's should have an annual patient volume of at least 4,000 and located in high density urban areas.

Population Health and Spend Management Companies

Population health management platforms are essential to managing population health risk in a capitated reimbursement environment and in the development of ACO's.  Ascendant wishes to invest in or joint venture with population health management companies to enable ACO development,

Ascendant has identified specialized "spend management" data companies that benchmark data on prices and clinical outcomes of devices as a niche that will benefit from the hospitals' shift to value-based purchasing - reduce costs and improve clinical outcomes in the purchasing of devices.