Hospitals entering into accountable care agreements are agreeing to essentially change the way care is delivered and assessed. Those embracing the growing ACO trend are also implementing structural changes in how they interact with physicians, staff and patients — all in an effort to stabilize or reduce costs and improve the quality of care.
Here are five tips for ACOs to improve connectivity and achieve desired outcomes.
1. Be an educated buyer of ACO IT systems. Properly coordinating care in an ACO necessitates an integrated and user-friendly information technology system. However, the potential for ACOs to grow through acquisitions and affiliations could make IT solutions difficult to implement, manage and support, says Eric Zerneke, vice president of sales and marketing for Arcadia Solutions..
"Healthcare organizations are not in the business of being IT organizations, but they need to be educated buyers and users of IT," he says.
Integrating systems across an ACO, along with remediating older systems and setting up go-live support and long-term support features requires personnel, skills and experience.
An ACO should know its own in-house IT capability and consider what may need to be outsourced to industry experts, such as infrastructure, hosted EHRs, data analytics and reporting, and implementation and support services.
At the end of the day, an ACO may only be as successful as the data it reports. Taking the time to figure out the best means of data integration and sharing across the ACO can save money and headaches in the long run.
"Treat your data and information as a key organizational asset and it will allow everyone to make educated decisions and balance the risks and rewards for the entire organization," Mr. Zerneke says.
2. Know how to use the data you collect. "Trusted data must be turned into trusted information that is available to everyone at the point of care," Mr. Zerneke says. "This includes not only clinical information from many sources, but financial analysis of high-cost and high-risk patients."
He says it's also important to coordinate information across many physicians — for example, providing discharge orders from the emergency department to the primary care physician.
Data collected about an ACO's patient population is critical information that may help the organization achieve its desired results. It's important for ACOs to have the tools and the know-how to use them to improve patient population outcomes.
3. Establish care management plans. ACOs are introducing evidence-based clinical solutions in order to offer consistent care across the board. Establishing a care management plan includes both evaluating how to optimize payments as well as meet and manage patient needs.
Establishing an ACO and optimizing care management is a journey, says Rose Higgins, BSN, MPM, vice president for payor-provider solutions at McKesson. "It's only for those interested in taking a performance risk road."
But the road can pay off in the end if the ACO successfully achieves what it sought out to do from the start — improve the cost of care and deliver better patient outcomes.
4. Manage population health risks. ACOs are also considering how to manage disease and high-risk populations in order to consider both patient and cost of care. The scope of an ACO involves "more robust utilization management," Ms. Higgins says.
She says drilling down into patient population data can help an ACO improve outcomes and suggests ACO should get to know as much as it can about its patient population.
"Distil this so you understand who is in that population and what's the risk associated with that population," Ms. Higgins says.
5. Promote patient engagement and connectivity in medical homes. To engage patients and connect with medical homes, ACOs need to first gather the necessary information so they can begin to understand what is occurring across the organization. To form an integrated care delivery organization, ACO leaders must have the "ability to connect disparate systems," Ms. Higgins says.
Patient-centered medical homes — with an aim to deliver long-term, coordinated care for the patient using a primary care physician as a kind of quarterback who can guide the patient to the necessary care — are also crucial to the success of any ACO because they are a way to link disparate systems.
"You can have a medical home without an ACO, but you cannot have an ACO without a medical home," Ms. Higgins says.
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Here are five tips for ACOs to improve connectivity and achieve desired outcomes.
1. Be an educated buyer of ACO IT systems. Properly coordinating care in an ACO necessitates an integrated and user-friendly information technology system. However, the potential for ACOs to grow through acquisitions and affiliations could make IT solutions difficult to implement, manage and support, says Eric Zerneke, vice president of sales and marketing for Arcadia Solutions..
"Healthcare organizations are not in the business of being IT organizations, but they need to be educated buyers and users of IT," he says.
Integrating systems across an ACO, along with remediating older systems and setting up go-live support and long-term support features requires personnel, skills and experience.
An ACO should know its own in-house IT capability and consider what may need to be outsourced to industry experts, such as infrastructure, hosted EHRs, data analytics and reporting, and implementation and support services.
At the end of the day, an ACO may only be as successful as the data it reports. Taking the time to figure out the best means of data integration and sharing across the ACO can save money and headaches in the long run.
"Treat your data and information as a key organizational asset and it will allow everyone to make educated decisions and balance the risks and rewards for the entire organization," Mr. Zerneke says.
2. Know how to use the data you collect. "Trusted data must be turned into trusted information that is available to everyone at the point of care," Mr. Zerneke says. "This includes not only clinical information from many sources, but financial analysis of high-cost and high-risk patients."
He says it's also important to coordinate information across many physicians — for example, providing discharge orders from the emergency department to the primary care physician.
Data collected about an ACO's patient population is critical information that may help the organization achieve its desired results. It's important for ACOs to have the tools and the know-how to use them to improve patient population outcomes.
3. Establish care management plans. ACOs are introducing evidence-based clinical solutions in order to offer consistent care across the board. Establishing a care management plan includes both evaluating how to optimize payments as well as meet and manage patient needs.
Establishing an ACO and optimizing care management is a journey, says Rose Higgins, BSN, MPM, vice president for payor-provider solutions at McKesson. "It's only for those interested in taking a performance risk road."
But the road can pay off in the end if the ACO successfully achieves what it sought out to do from the start — improve the cost of care and deliver better patient outcomes.
4. Manage population health risks. ACOs are also considering how to manage disease and high-risk populations in order to consider both patient and cost of care. The scope of an ACO involves "more robust utilization management," Ms. Higgins says.
She says drilling down into patient population data can help an ACO improve outcomes and suggests ACO should get to know as much as it can about its patient population.
"Distil this so you understand who is in that population and what's the risk associated with that population," Ms. Higgins says.
5. Promote patient engagement and connectivity in medical homes. To engage patients and connect with medical homes, ACOs need to first gather the necessary information so they can begin to understand what is occurring across the organization. To form an integrated care delivery organization, ACO leaders must have the "ability to connect disparate systems," Ms. Higgins says.
Patient-centered medical homes — with an aim to deliver long-term, coordinated care for the patient using a primary care physician as a kind of quarterback who can guide the patient to the necessary care — are also crucial to the success of any ACO because they are a way to link disparate systems.
"You can have a medical home without an ACO, but you cannot have an ACO without a medical home," Ms. Higgins says.
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