important resource in an ACO. Whether the MPI exists at the single-system, facility, enterprise or HIE level, standards and interoperability are key to building and maintaining it. As such, it demands active data stewardship, data governance and many collaborative processes. Traditional MPIs, however, aren’t designed for the in-
creased array, amount and alacrity of the big data that comes with ACOs. T ey simply are too expensive, too slow and too inaccurate. Today’s patient-centric ACO needs a new kind of MPI, able to process huge amounts of data to link the activities of all individuals – patients, providers or health plan members – to coordinate care within the organization and across the continuum.
Charles Kennedy, M.D., CEO, Accountable Care Solutions from Aetna
Building a technology framework for ACO success A major diff erence between today’s accountable care models and the HMOs of the 1990s lies in the technology available to share patient information, coordinate across diff erent care providers and better involve patients. Without the right technology, providers will be unable to enhance proactive, population-based medicine. Deploying health information technology that allows the
care team to share and act on patient information among disparate care providers is crucial. Technology supports a team-based approach to care in other ways, including: Advanced analytics to identify and manage risk. T e right analytics help fl ag at-risk individuals and fi nd gaps in care. As a result, organizations can make more targeted interventions, assess overall performance and improve care. Real-time clinical analytics at the point of care. Integrat- ing clinical and claims data and analyzing it for consistency with individualized evidence-based recommendations helps providers improve an individual’s care and can improve provider productivity through an easier understanding of the patient’s history. Patient engagement tools. Online and mobile applications
support patients between offi ce visits and promote healthy lifestyles. T ese tools help encourage individuals to use the healthcare system effi ciently, make lasting health improve- ments and better manage their chronic conditions. T e right type of data-sharing platform enables provid- ers to better monitor and manage chronic conditions, de- liver timely preventive care and improve outcomes. To- gether, these technologies deliver vital information how and when it is needed most. With access to actionable, real-time insight, every member of a patient’s care team can achieve
the triple aim: improved quality, lower costs and a better patient experience.
Jay Spence, VP of product and industry solutions, Axiom EPM
Data analysis key to successful ACOs Given the recent shift to aff ordable care and other value- based models, determining the cost of care is more important than ever. Finance execs at healthcare organizations across the country are feeling the pressure to revamp accounting and budgeting strategies so that the y can operate more ef- fi ciently while eff ectively curbing costs associated with an ACO model. Traditional methods of fi nancial planning, accounting and budgeting are simply insuffi cient because they are inadequate in measuring the true cost of care at the patient level. More fi nance teams are questioning how their team can
support their organization and overcome the challenges as- sociated with the shift to value-based care and ACO models. Finance teams must shift their time away from tedious data aggregation functions and spend more delivering value- added analysis, identifying trends and using analytics to advise business decisions that impact profi tability. Finance teams are turning to technology to help them streamline and automate budgeting, planning and costing processes, focusing on analysis and initiatives to reduce costs. Eff ectively using service-line volume, costs and profi t- ability metrics to support strategic business decisions are becoming requirements to supporting cost-containment initiatives and maintaining or even growing profi tability. Hospitals are using this data to formulate integrated business planning across their lines of service and infl uence revenue, reimbursements and, most commonly, operational plans. Organizations relying heavily on data and analysis to better determine the true cost of care are making better decisions and are able to control costs without impacting the quality of care, an important step to participating in an ACO.
Philip Spinelli, senior VP, ikaSystems
Redefi ning the source of care management delivery T e Accountable Care Act is driving signifi cant change within the healthcare industry. To thrive in this new land- scape, healthcare payers will need to redefi ne the source of care management delivery. T ey should put in place the
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