● Roundup: ACOs
proper IT infrastructure to facilitate care coordination and population health management, and interact with patients in an eff ort to manage costs more eff ectively. As payers move to embrace the ACO model and drive patient engagement, a critical success factor will be the ability to deliver fully integrated data, in real time, for immediate insight. T is will create the single consolidated view of pa- tient data that is required to achieve the maximum benefi t in terms of quality of care, patient safety and reduction in healthcare expense. Additionally, payers will need to optimize the core capa- bilities needed to facilitate this changing care management model. T is will include registering and managing a popula- tion as a defi ned entity or group, using predictive modeling to identify, stratify and prioritize care within that population, manage chronic disease rates, engage the patient, coordinate patient care among multiple professionals and regions or facilities, and provide access to evidence-based medicine guidelines and knowledge in real time. T e ability to integrate data into a single view and provide
true insight in real time will be the key diff erentiators in today’s environment and thus fuel the need to modernize systems. Organizations that can implement this infrastruc- ture quickly will have a strategic advantage over those that take a longer or more staged approach.
Katherine Schneider, M.D., executive VP and CMO, Medecision
Three pillars for ACO success: strategy, people and technology Hospitals moving toward becoming an ACO need to
answer the following question: Is the ACO a service line within the hospital, or is the hospital a service line within the ACO? T e answer determines your structure – from the right strategy and people to the right technology. T e fi rst structural pillar of a successful ACO is strategic alignment. Simply put, your ACO strategy must change how you do business for the long term, to the ultimate benefi t of patients. T erefore, aligning the right ACO strategy with organizational goals to transform care quality and cost ef- fectiveness is critical. T e second pillar centers on people. To build a success-
ful ACO, educate key people on the ACO strategy, and in alignment with that strategy, be sure you are measuring what matters to them. Additionally, ask providers if the data being captured contributes in a meaningful way to the outcomes you’re trying to achieve – for processes and patient care. Finally, gain buy-in from a leader who champions the
8 July 2013
ACO strategy, early adopters who embrace the change and a patient/family advisory council to provide user insight. A good litmus test of your success is the diff erence patients – not providers – feel as participants in your ACO. When done right, patients will notice a change for the better. T e third pillar hinges upon using the right technology
to improve business and clinical decisions. Yet technology should not drive changes in patient care. Instead, patient care must drive innovation in technology, as it is only useful if it solves meaningful patient problems. A successful ACO is all about improvement through
measurement, so step back and look at your ACO in a non- traditional way. T at way, through your strategic goals, people and technology, you can be sure you are measuring what matters.
Noel Khirsukhani, PatientPoint
Five tips for successful accountable care T e excessive costs of healthcare and regulatory reform
are changing the way healthcare is delivered and paid for in the United States. Patient engagement eff orts have become increasingly important to the fi nancial sustainability and clinical success of physician practices, and as healthcare organizations move toward an accountable care model. Here are ways they can succeed: 1. Formalize the organizational structure. Establish processes to promote quality of care, report on costs and coordinate care. Determine a governance and management structure for decision making, and legalize how the team plans to work together, get paid and develop the operational plan relative to technology.
2. Design an eff ective workforce. T e ability to design and allocate a healthcare workforce is critical to an ACO. T e ACO must manage physicians’ patient workload (empanelment) and encourage productivity in a team-based incentive structure so that all stake- holders are aligned in achieving the triple aim.
3. Invest in technology. Hospitals and physician practices today are realizing the true potential of technology in changing the way both physicians and patients approach disease management. Assuming that physicians have already implemented an elec- tronic medical record (EMR) system, ACOs need to invest in technologies that help identify gaps in care, align the physician and the patient, and moni- tor patient adherence and compliance. Together,
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