At an Oct. 5 listening session on antitrust enforcement for accountable care organizations, FTC representatives asked whether possible waivers from antitrust laws should require ACOs to have certain basic attributes, such as use of electronic medical records.
Speakers on a panel of stakeholders suggested IT capabilities could vary, but some form of IT would be needed to process patient care information, a core function of ACOs. "You need to be able to share data," said Terry Carroll, CIO of Fairview Health Services in Minneapolis. But EMR may not be one of the necessary attributes, said Lee Sacks, MD, president of Advocate Physician Partners. His group has been clinically integrated without having an EMR for 6-7 years, but Advocate is now installing one.
Diversity and flexibility needed
The Alternative QUALITY Contract, an ACO-like arrangement created by Blue Cross Blue Shield of Massachusetts, "allows for enormous diversity," said Dana Gelb Safran, senior vice president for performance measurement and improvement at the company. More than half of the organizations in AQC are comprised of small practices with one to five physicians, often brought together for the AQC contract, she said.
While there should be some requirements for ACOs, there should be enough flexibility to allow for experimentation, said Lawrence Casalino, MD, chief of the Division of Outcomes and Effectiveness at Weill-Cornell Medical College. "You don’t want a lot of sham organizations and you don’t want well meaning but incompetent organizations that will fail," he said. On the other hand, "you don't want a 100 percent success rate." He added that the National Committee for Quality Assurance, which accredits managed care organizations, would probably create its own standards for ACOs.
Janet Wright, MD, senior vice president for services and quality at the American College of Cardiology, said some basic expectations could be formulated, such as bringing together a legitimate community of providers, having the ability to collect data, reflecting on the data to improve performance, educating providers to use the system and conducting research to find out what worked and what doesn’t.
Speakers on a panel of stakeholders suggested IT capabilities could vary, but some form of IT would be needed to process patient care information, a core function of ACOs. "You need to be able to share data," said Terry Carroll, CIO of Fairview Health Services in Minneapolis. But EMR may not be one of the necessary attributes, said Lee Sacks, MD, president of Advocate Physician Partners. His group has been clinically integrated without having an EMR for 6-7 years, but Advocate is now installing one.
Diversity and flexibility needed
The Alternative QUALITY Contract, an ACO-like arrangement created by Blue Cross Blue Shield of Massachusetts, "allows for enormous diversity," said Dana Gelb Safran, senior vice president for performance measurement and improvement at the company. More than half of the organizations in AQC are comprised of small practices with one to five physicians, often brought together for the AQC contract, she said.
While there should be some requirements for ACOs, there should be enough flexibility to allow for experimentation, said Lawrence Casalino, MD, chief of the Division of Outcomes and Effectiveness at Weill-Cornell Medical College. "You don’t want a lot of sham organizations and you don’t want well meaning but incompetent organizations that will fail," he said. On the other hand, "you don't want a 100 percent success rate." He added that the National Committee for Quality Assurance, which accredits managed care organizations, would probably create its own standards for ACOs.
Janet Wright, MD, senior vice president for services and quality at the American College of Cardiology, said some basic expectations could be formulated, such as bringing together a legitimate community of providers, having the ability to collect data, reflecting on the data to improve performance, educating providers to use the system and conducting research to find out what worked and what doesn’t.