At the Becker's Hospital Review Annual Meeting on Friday, May 18, Andrew Ziskind, MD, managing director of Clinical Solutions for Huron Healthcare, and Tim Ogonoski, managing director with Huron Healthcare, discussed accountable care organizations.
"Another theme of everything we're talking about: there's a lot of local market variability. It's the local market that is going to drive what you're seeing," said Dr. Ziskind.
Dr. Ziskind said providers shouldn't forget shared savings, as a model, can only sustain itself for so long. "The amount of shared savings has disappointed almost every group that has moved into this model," said Dr. Ziskind. He said the amount of shared savings is typically "well under" one million dollars per year, and he also pointed that this is a temporary model, as the amount of shared savings will eventually level out.
"It's almost irrelevant whether you're in an ACO. The relevant piece is that you need to be developing ACO-like competencies," said Dr. Ziskind. "When you start looking at the core competencies to be able to do this, you start seeing things like clinical coaches, analytics – a lot of capabilities that formerly lived in the payor world."
Most of today's ACO development is sponsored by hospitals and health systems, largely non-profit and community-based health systems. Much of this activity is due to these organizations' leaner decision-making process, capital capacity to support infrastructure and a strong position in their local markets, according to Dr. Ziskind. Most payors are still trying to sell their services to healthcare providers, according to Dr. Ziskind, as they have many of the ACO capabilities. A few payors, such as Highmark, are actually moving into the realm of delivery systems, but that is less common.
Mr. Ogonoski discussed patient-centered medical homes and their relationship to ACOs. In a PCMH, patients have ongoing relationships with a personal PCP who is their first contact for care and also helps coordinate their care across acute-care, chronic care, preventive and various other care settings. Mr. Ogonoski said that while the PCMH and ACO models share similarities, they are not dependent on one another. "You don't have to have an ACO to have a PCMH, and you don't need a PCMH to have an ACO," he said.
Challenges facing ACOs include moving from FTC-validated clinical integration to "true" clinical integration. The latter reflects a commitment from physicians to improve quality and reduce clinical variation in treatments. The "stickiness" of physician-patient relationships is also a challenge. "When you care for a patient, you don't want that patient hopping from one health system to another," said Dr. Ziskind.
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"Another theme of everything we're talking about: there's a lot of local market variability. It's the local market that is going to drive what you're seeing," said Dr. Ziskind.
Dr. Ziskind said providers shouldn't forget shared savings, as a model, can only sustain itself for so long. "The amount of shared savings has disappointed almost every group that has moved into this model," said Dr. Ziskind. He said the amount of shared savings is typically "well under" one million dollars per year, and he also pointed that this is a temporary model, as the amount of shared savings will eventually level out.
"It's almost irrelevant whether you're in an ACO. The relevant piece is that you need to be developing ACO-like competencies," said Dr. Ziskind. "When you start looking at the core competencies to be able to do this, you start seeing things like clinical coaches, analytics – a lot of capabilities that formerly lived in the payor world."
Most of today's ACO development is sponsored by hospitals and health systems, largely non-profit and community-based health systems. Much of this activity is due to these organizations' leaner decision-making process, capital capacity to support infrastructure and a strong position in their local markets, according to Dr. Ziskind. Most payors are still trying to sell their services to healthcare providers, according to Dr. Ziskind, as they have many of the ACO capabilities. A few payors, such as Highmark, are actually moving into the realm of delivery systems, but that is less common.
Mr. Ogonoski discussed patient-centered medical homes and their relationship to ACOs. In a PCMH, patients have ongoing relationships with a personal PCP who is their first contact for care and also helps coordinate their care across acute-care, chronic care, preventive and various other care settings. Mr. Ogonoski said that while the PCMH and ACO models share similarities, they are not dependent on one another. "You don't have to have an ACO to have a PCMH, and you don't need a PCMH to have an ACO," he said.
Challenges facing ACOs include moving from FTC-validated clinical integration to "true" clinical integration. The latter reflects a commitment from physicians to improve quality and reduce clinical variation in treatments. The "stickiness" of physician-patient relationships is also a challenge. "When you care for a patient, you don't want that patient hopping from one health system to another," said Dr. Ziskind.
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