At the Becker's Hospital Review Annual Meeting on May 18 in Chicago, Dana Gilbert, vice president of clinical innovation for Advocate Physician Partners in Oak Brook, Ill., explained hos health systems can make the transition toward an accountable care organization.
Mr. Gilbert said physicians are highly motivated individuals and want to be successful, and the success of an ACO hinges entirely on whether a health system can fully engage their physicians. "We found clinical integration has been a great stepping stone to ACO formation and development," Mr. Gilbert said. "Physicians are really interested in partnering and working with successful organizations."
APP formed an ACO with Blue Cross Blue Shield of Illinois to cover 350,000 lives. Two-thirds of all Advocate Health Care physicians are with APP, a voluntary group, and Mr. Gilbert said engaging physician in the governance of the organization has led its success.
For 2012, APP has 159 individual performance measures, and many of the metrics focus on clinical outcomes, efficiency, medical and technological infrastructure, patient safety and patient satisfaction. Seventy percent of the monetary incentives are individual-based while 30 percent are group-based.
They have been able to add more physicians to its membership rolls because of their open-mindedness and sound evidence-based metrics. "We have a lot of different areas to increase compliance and performance," Mr. Gilbert said. "The goal is to be driven by physician leadership and executives and create an organization where membership is valued."
In the end, hospitals and physicians must realize Medicare and Medicaid finances are not sustainable, among many other challenges, and physician-led ACO efforts will power the new age of population health, he said.
Mr. Gilbert said physicians are highly motivated individuals and want to be successful, and the success of an ACO hinges entirely on whether a health system can fully engage their physicians. "We found clinical integration has been a great stepping stone to ACO formation and development," Mr. Gilbert said. "Physicians are really interested in partnering and working with successful organizations."
APP formed an ACO with Blue Cross Blue Shield of Illinois to cover 350,000 lives. Two-thirds of all Advocate Health Care physicians are with APP, a voluntary group, and Mr. Gilbert said engaging physician in the governance of the organization has led its success.
For 2012, APP has 159 individual performance measures, and many of the metrics focus on clinical outcomes, efficiency, medical and technological infrastructure, patient safety and patient satisfaction. Seventy percent of the monetary incentives are individual-based while 30 percent are group-based.
They have been able to add more physicians to its membership rolls because of their open-mindedness and sound evidence-based metrics. "We have a lot of different areas to increase compliance and performance," Mr. Gilbert said. "The goal is to be driven by physician leadership and executives and create an organization where membership is valued."
In the end, hospitals and physicians must realize Medicare and Medicaid finances are not sustainable, among many other challenges, and physician-led ACO efforts will power the new age of population health, he said.
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