At the Becker's Annual CEO Strategy Roundtable, held Nov. 14 in Chicago, Robert C. Sehring, chief ministry service officer of Peoria, Ill.-based OSF Healthcare System, discussed OSF's rationale behind becoming one of CMS' Pioneer Accountable Care Organizations.
"The idea was aligned with OSF's values and mission and was consistent with our strategic plans and vision," Mr. Sehring said. The alignment, along with the opportunity for OSF to collaborate with other ACOs and the system's desire to make care more affordable for the population its serves, encouraged the system to move forward with the program.
OSF's ACO participation has reduced admissions, readmissions and length of stay, decreased its emergency department visits and improved inter- and intra-facility and patient communication, Mr. Sehring said.
OSF moved the needle through investing in data analytics, an office-based care program, a transitional care program and a skilled nursing facility practice program. It also put together care teams, which have evolved according to the desires of patients and providers.
Care teams started out with a registered nurse care manager, but when it became apparent many nurses were uncomfortable and unprepared to deal with psychosocial factors contributing to patients' ill health, OSF brought on social workers and other non-nursing staff to support the care teams so they could help patients get and stay well.
OSF's care transition strategy is particularly important. The process includes a rigorous system of checklists, immediate follow-ups and relentless rounding to ensure all steps of the process are working at full efficiency at all times. The strategy has worked very well, according to Mr. Sehring.
However, despite its success, OSF's ACO participation is not without significant challenges.
The system has dealt with limited resources for psychology and substance abuse and a shortage of primary care physicians. It has also seen firsthand the reluctance of primary care physicians to delegate patient care tasks to other staff.
From a systemic perspective, Mr. Sehring said OSF was concerned about the consistency of ACO evaluation metrics has they are applied to very different systems. CMS' slow provision of benchmarking data — nearly a six month lag — has created additional difficulties.
However, OSF remains optimistic about the potential of the ACO to facilitate achievement of the triple aim. The system has continued to experiment with expanding access to care, helping patients with transportation, improving referral management and engaging through telemedicine.
"The three takeaways we have are that data is critical, you can never overcommunicate, and change is hard," said Mr. Sehring. "Essentially, change management is critical."