In a session at the Becker's Hospital Review 5th Annual Meeting in Chicago on May 16 th, Kayur Patel, MD, medical director at Premiere Health Consulting, discussed how to align hospitals and physicians to meet CMS' quality agenda.
Accountable care organizations have popped up in response to the new focus on quality care. Dr. Patel defines ACOs as "a [health maintenance organization] with a twist.
"In the 1908s, HMOs were about finances. Where can I get the cheapest? [Now, ACOs] are where can I get the best quality care and the cheapest?" he said.
Physician profiling is becoming a tool to marry the two sides of affordable care and quality care by tying in metrics to choose physicians, Dr. Patel said.
With the help of CMS' quality metrics and HCAHPS scores, payers now know who the good physicians are, and consumers are starting to access this information.
Historically, financially driven consumers may only look for the cheapest physicians, while quality-driven consumers would look for the best physicians. However, with the accumulation of quality metrics available, everyone is looking for the top physicians, Dr. Patel said.
Payers want the top physicians because it lessens the likelihood of readmission and complications, so now they are steering all patients to these physicians with the data to back up their quality practice.
"Can we give our patients access to good quality medicine?" Dr. Patel asked. "Ultimately, that's where they're going to go."
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