Three healthcare experts weighed in on accountable care organizations during a panel session at the Becker's Hospital Review Annual Meeting May 20. The panel included Martin Manning, president of Oak Brook, Ill.-based Advocate Physician Partners; Brian J. Silverstein, MD, senior vice president of the healthcare consulting firm Camden Group; and Eric T. Nielsen, MD, vice president of the Camden Group. The panel shared the following five thoughts on their experiences with ACO development.
1. A clinical integration model is a must. Advocate Physician Partners launched its Clinical Integration Program in 2004. The program has laid the groundwork for an ACO, with more than 3,800 physicians participating in the program in 2010 and collaborating on 41 initiatives and 116 quality measures. Dr. Nielsen said this type of model is a "must" for organizations on track to develop ACOs since it sets the foundation in terms of operation and infrastructure.
2. Engage physicians through education and small-group conversations. When it comes to physician engagement, Dr. Nielsen recommended hospital leaders offer extensive education on the ACO model. "Physicians are skeptical. They're trained to be that way. Answer all of their questions," Dr. Nielsen recommended. "Have one-on-one conversations and talk in small groups." Mr. Manning also recommended making a place for the formal and informal leaders on the medical staff in physician engagement efforts.
3. Lack of employed physicians may not be a deal-breaker. In regards to long-term goals and physician employment, Mr. Manning says he is neutral on whether physicians are employed or independent. "From a care management perspective, I don't really care," says Mr. Manning. "Care involves a team, a continuum. We need to erase the lines between private practice and employed physicians and ask whether the team works well together." Approximately 3,800 physicians are on Advocate's medical staff, caring for a million people. Dr. Nielsen also said this distinction is not the end-all-be-all of ACO development. "As for performance, we've found no difference between employed and independent physicians," says Dr. Nielsen.
4. Know the payors in your area. When should hospitals go forward with payors to develop ACO payment arrangements? "We would be happy to talk at any stage in ACO development," says Dr. Silverstein. "The more developed the hospital is, the more we'll know how soon we can act." He recommends hospitals know the payors in their area and how aggressive they will be in ACO development. Mr. Manning also recommended hospitals put together a value report and focus on the business case for this new level of partnership.
5. Pick one model and focus on making it successful. In a rapidly evolving healthcare industry, new models of care seem to emerge every other month. Dr. Silverstein recommends hospitals keep it simple. "Any hospital should pick one model and make sure administrators have time to make it successful. Don't try and develop 15 different models. Pick one and build on it," says Dr. Silverstein.
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1. A clinical integration model is a must. Advocate Physician Partners launched its Clinical Integration Program in 2004. The program has laid the groundwork for an ACO, with more than 3,800 physicians participating in the program in 2010 and collaborating on 41 initiatives and 116 quality measures. Dr. Nielsen said this type of model is a "must" for organizations on track to develop ACOs since it sets the foundation in terms of operation and infrastructure.
2. Engage physicians through education and small-group conversations. When it comes to physician engagement, Dr. Nielsen recommended hospital leaders offer extensive education on the ACO model. "Physicians are skeptical. They're trained to be that way. Answer all of their questions," Dr. Nielsen recommended. "Have one-on-one conversations and talk in small groups." Mr. Manning also recommended making a place for the formal and informal leaders on the medical staff in physician engagement efforts.
3. Lack of employed physicians may not be a deal-breaker. In regards to long-term goals and physician employment, Mr. Manning says he is neutral on whether physicians are employed or independent. "From a care management perspective, I don't really care," says Mr. Manning. "Care involves a team, a continuum. We need to erase the lines between private practice and employed physicians and ask whether the team works well together." Approximately 3,800 physicians are on Advocate's medical staff, caring for a million people. Dr. Nielsen also said this distinction is not the end-all-be-all of ACO development. "As for performance, we've found no difference between employed and independent physicians," says Dr. Nielsen.
4. Know the payors in your area. When should hospitals go forward with payors to develop ACO payment arrangements? "We would be happy to talk at any stage in ACO development," says Dr. Silverstein. "The more developed the hospital is, the more we'll know how soon we can act." He recommends hospitals know the payors in their area and how aggressive they will be in ACO development. Mr. Manning also recommended hospitals put together a value report and focus on the business case for this new level of partnership.
5. Pick one model and focus on making it successful. In a rapidly evolving healthcare industry, new models of care seem to emerge every other month. Dr. Silverstein recommends hospitals keep it simple. "Any hospital should pick one model and make sure administrators have time to make it successful. Don't try and develop 15 different models. Pick one and build on it," says Dr. Silverstein.
Related Articles on ACOs:
ACOs Inspire Doubts, Criticisms of "HMO Redux"
ACOs: Spend Now to Save Later?
7 Senators Ask CMS to Withdraw Proposed ACO Regulations