Making the move to accountable care is a big step — and one that requires the support of all stakeholders throughout the continuum of care. By creating an environment that is receptive to and supportive of new and emerging care models, hospitals, health systems and physician practices can pave the way for a successful transition that drives innovation and produces tangible results.
Achieving lasting transformation
Building a culture that supports accountable care takes time, but it's worth the effort. Whether you're just beginning your journey or you're well on your way, here are some basic dos and don'ts for securing buy-in at all levels:
• Do: Communicate a clear vision for accountable care. Value-driven models represent a completely different approach to care, so healthcare leaders must help clinicians and other staff members understand how the transition impacts them as well as how they can contribute to it. They must also be prepared to explain exactly what type of changes to expect. For example, to offset any volume reductions resulting from clinical efficiencies, some healthcare organizations may choose to launch a co-branded health plan with a payer. By doing so, they can attract new patients and drive market share growth.
• Don't: Overlook the importance of the patient. Before accountable care organizations can achieve the three-part aim of lower costs, higher quality care and better population health, they must fully engage patients and make them active participants in their care. Putting patients at the center of care efforts results in higher satisfaction, more informed decisions and better outcomes. A recent study showed patients who were active in their care were less likely to be readmitted to the hospital (12 percent vs. 28 percent) or experience a medical error (20 percent vs. 35 percent).
• Do: Enable a team-based approach to care. For stronger care collaboration to take place, provider organizations must use a wide range of advanced capabilities, such as risk stratification tools, predictive modeling, clinical decision support, data aggregation and exchange, care management systems and business intelligence tools. With the help of these capabilities, organizations can make vital patient information accessible at the point of care in a way that's both timely and actionable. When used as part of new workflows and processes optimized for value-driven models, providers are empowered to take a more team-based approach to care. They can also be more proactive, whether responding to the health needs of entire populations or individual patients.
• Do: Close the gaps between clinical and financial worlds. In the past, there was little overlap between the clinical and financial functions of a healthcare organization. With the advent of value-driven care, however, these norms are rapidly changing. To measurably improve outcomes, lower costs and increase efficiencies, clinical and financial leaders must learn to collaborate in new ways. By working together, these departments can produce more sophisticated reports and analytics than each one could on its own. With this data in hand, healthcare organizations have valuable insight they can then leverage to set themselves apart from the competition and better meet the demands of today's evolving healthcare marketplace.
• Don't: Be afraid to adjust your strategy. Ending programs that aren't working well is essential for long-term success. By consistently measuring progress and outcomes metrics, ACOs can see how well they are performing and if this performance aligns with accountable care goals. Healthcare leaders can also focus their efforts on programs that have the biggest impact and refine those that aren't meeting expectations. By continuously reviewing small tests of change and making adjustments along the way, everyone across the enterprise can stay focused on the same goals, to drive meaningful and lasting transformation.
With an organizational culture that supports value-driven care models, healthcare leaders can ensure their accountable care initiatives reach their full potential. The key is to actively involve clinical, business and administrative staff in the change and unite them in the pursuit of higher quality, lower costs and a better patient experience.
With an organizational culture that supports value-driven care models, healthcare leaders can ensure their accountable care initiatives reach their full potential. The key is to actively involve clinical, business and administrative staff in the change and unite them in the pursuit of higher quality, lower costs and a better patient experience.
Gary Anthony currently serves on the leadership team of Accountable Care Solutions from Aetna with a focus on the technology, care management and advisory services necessary for a provider organization to successfully move from episodic, fee-for-service care to a population health, value-based-care operating model.
[i] AARP study, "Chronic Care: A Call to Action for Health Reform."
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