2020 Award Winners

The Together 2 Goal® campaign is pleased to honor the following participating organizations for their achievements in diabetes care.

Best Performance

The “Best Performance” categories recognize the highest performers across different group sizes who self-report data to the campaign on the diabetes bundle measure. This measure includes blood sugar and blood pressure control rates, statin management, and medical attention for kidney disease.

Best Performance – Small Group

Coastal Carolina Health Care, P.A.

Best Performance – Medium Group

USMD Health System

Best Performance – Large Group

Scripps Medical Foundation

Innovation

The new “Innovator” categories recognize organizations who, through participation in the Together 2 Goal® Innovator Track, successfully drove rapid improvement in additional measures relating to cardiovascular disease and eye health.

T2G Innovator for Cardiovascular Health

Premier Medical Associates, P.C.

T2G Innovator for Eye Health

Prevea Health

2020 Award Winners [+]

The Together 2 Goal® campaign is pleased to honor the following participating organizations for their achievements in diabetes care.

Best Performance – Basic Track

The “Best Performance – Basic Track” category recognizes the highest performer whose self-reported data to the campaign is limited to blood sugar control rates.

INOVA/Signature Partners

Best Performance – Core Track

The “Best Performance – Core Track” categories recognize the highest performers across different group sizes who self-report data to the campaign on the diabetes bundle measure. This measure includes blood sugar and blood pressure control rates, statin management, and medical attention for kidney disease.

Best Performance – Core Track (Small Group)

Coastal Carolina Health Care, P.A.

Best Performance – Core Track (Medium Group)

USMD Health System

Best Performance – Core Track (Large Group)

Scripps Medical Foundation

Together 2 Goal® is pleased to honor the following participating organizations for their achievements in diabetes care.

Best Performance – Large Group

Best Performance – Small Group

Most Improved – Large Group

Most Improved – Small Group

Honorable Mention

Together 2 Goal® asked each award winner what they felt was critical to their success, and a number of themes emerged. They attributed their impressive patient outcomes to the following activities, many of which are part of the campaign planks:

• Building accountable, coordinated diabetes care teams

• Fostering collaboration between primary care physicians, diabetes case managers, clinic nurses, specialists, and other members of the care team

• Increasing physician awareness of diabetes programs

• Collaborating with patients to set achievable goals

• Offering and promoting patient self-management tools and programs (e.g., nutrition, group classes)

• Ordering labs in advance of patient appointments to inform care plans

• Streamlining care processes to enhance efficiency

• Educating care team members on protocols and workflows

• Outreaching to patients, particularly those who hadn’t met their targets, to schedule follow-up visits

• Conducting intensive case management of patients with diabetes and multiple comorbidities

• Developing and utilizing electronic patient registries

• Creating actionable, embedded point-of-care tools

• Emphasizing careful documentation to capture quality performance and identify care gaps

• Leveraging organization-wide, transparent monthly reports to track performance at the provider and organization level

• Benchmarking progress against medical groups nationwide via Together 2 Goal® blinded comparative data reports

• Adopting best practices from other Together 2 Goal® groups and internal advisory committees

All seven organizations were recognized at the AMGA Foundation Donor Reception during AMGA’s 2018 Annual Conference.