Newsletter for Physicians and Clinical Staff
A letter by Paul McLeod, M.D., MED3OOO Chief Medical Executive
I can’t seem to get through a single day without seeing another article about Accountable Care Organizations (ACOs). This may be the most heralded movement in health care delivery in the past 20 years. With careful analysis, it is apparent that these new organizations will incorporate many tried and true tactics from past years. Tactics that did not, by themselves, result in cost control or high quality. One has to wonder why we would have such hope that this time will be different. I am not certain that it will work this time, but I believe that it can. Here are some thoughts.
- A Very Comprehensive Program
Populations of patients, even those confined to seniors, represent a diversity of gender, culture, and medical risk. ACOs will be required to provide for the needs of each of them. That will bring to bear a full complement of services targeted at those for whom they will bend the cost curve and improve clinical outcomes. The menu will include Patient Outreach, Evidence-Based Medicine, Disease Management, Case Management, Demand Management, and Predictive Modeling. Successful provider networks will efficiently utilize health coaches and other high touch interventions as well. Success will require the full complement of programs and services. The comprehensive network is a key to success.
- The Technology is Finally Available
Previous attempts to control cost and quality were not adequately supported by technology infrastructure. Things have changed. Very good EMRs are ready for prime time and affordable. Even more powerful is the combination of EMR with patient recall, information sharing between providers, electronic referrals, and systems to manage utilization, pay claims, and produce predictive modeling reports. Add a data warehouse with robust granular reporting, and ACOs will be able to measure what they need to manage. Success is within reach this time. A major barrier will be significant start-up cost.
- Positive and Negative Incentives
Behavior is all about incentives. When incentives don’t support desired outcomes, opportunity is lost. Incentive alignment across the spectrum of providers and their patients does not exist today. The world of ACOs may be our best attempt yet to change that deficiency. In an environment of shared losses or gains, the players will need to create aligned incentives that support cost and quality outcomes across the provider spectrum. This could be the most difficult challenge faced by ACOs.
We have an opportunity to succeed this time. The stakes have never been higher. But which providers will rise to the top? Will it be hospitals? Physician groups? Health plans? The answer is all of the above. It is more about what we do, rather than who we are. MED3OOO is poised to work with ACOs to create the programs and infrastructure needed to succeed in this new paradigm.
Want to find out more about MED3OOO’s ACO infrastructure and development strategy email Marketing@MED3000.com.
For a printable version of this newsletter click here: March Clinical 2012
The Clinical Advisory is a clinical publication from MED3OOO dedicated to informing physicians and clinical staff about tools and information to improve the quality of patient care.
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