Quorum Health Resources Executive Director of ACOs Susan MacLeod discusses how community hospitals are engaging with ACOs and what to expect in the future.
Question: What are the unique challenges and opportunities for community hospitals participating in ACOs?
Susan MacLeod: Hospitals participating in ACOs are more engaged in strategies and planning for population health improvement. Having access to beneficiary claims data through CMS gives hospitals access to new analysis regarding patients' health needs and choices.
Through ACOs, community hospitals are strategizing and developing wellness initiatives. Furthermore, instead of managing disconnected services, providers are experiencing improved satisfaction with the continuous care model of an ACO.
Q: How are community hospitals approaching risk management with ACOs and population health? What are they doing more of? What are they doing less of?
SM: Improving population health includes quality of care, communication amongst providers, community services, agencies and wellness strategies. Hospitals are seeing that meaningful quality metrics and effective caregiver communication helps facilitate accountable care throughout the patient's health journey.
Hospitals have been focused on patient centricity for a long time. The patient engagement initiatives at the site of care are helping achieve that centricity. When hospitals reach their community with healthy lifestyle initiatives, consumers can identify health risks earlier and engage in proactive care.
Q: What do you see the smartest community hospital CEOs doing today to prepare for tomorrow?
SM: Engaging with providers to meet quality and patient expectations in changing payer models is a high priority for CEOs. While the Tier 1 Medicare Shared Savings Program ACOs are non-risk bearing, the evolving models do require risk. Providers will use the skills and processes learned in their current ACO models to make that transition and meet performance expectations. To prepare for tomorrow, community hospital CEOs need to identify any barriers to this transition, while continuing efficiency and quality improvement.
Q: How do you expect the community hospital landscape to change over the next 10 to 15 years?
SM: The community hospital focus will reach further into the community to address the overall health of its population. Consumers will influence where they receive care and how they communicate. Wellness will consist of more than an annual exam or fitness center. Payers will continue to seek higher performance in quality and engagement while decreasing costs per beneficiary.
Community hospitals are coordinating the services to maximize benefits for patients in the community. The hospital is the central component of this value model.