19 Questions to Ask on the Road to Accountable Care

A recent report by Valence Health provides a list of 19 questions health systems should ask as they work to develop accountable care.

Providing accountable care, according to Valence Health, requires capabilities across four foundational areas: clinical integration, care coordination, information technology and financial management.

The report outlines various questions health system leaders should ask to assess their organizations' capabilities within each of the four areas.

Clinical integration
  • Do we have engaged physician leaders with the vision and commitment to pursue clinical integration and accountable care?
  • Do our physicians understand and can they envision bridging the gap between fee-for-service and population-based care delivery?
  • Do we currently have a clinically or financially integrated network of providers, or will we have to form a new legal entity?
  • Do we have the governance structures with the status and credibility to make and enforce decisions about care management and providers' ongoing participation in the network?

Care coordination
  • How do we measure performance? Do we have tools and data to measure and identify variances?
  • Do our providers embrace and practice according to evidence-based guidelines?
  • Do we have the resources and staff to identify gaps in care, track and engage patients and coordinate their care?
  • Do we have the leverage to engage physicians and ensure alignment with clinical quality/value objectives?
  • Do we have the care coordination resources to engage patients, conduct outreach, measure feedback and improve patient experience?
  • Do we have scope or affiliations to facilitate integrated care delivery across the continuum?
  • Are systems and incentives designed and aligned to deliver the desired outcomes?
  • If not, do we have or can we develop plans, strategies and resources to address these areas effectively and in a timely manner?

Information technology
  • Do we have baseline data to measure physician performance?
  • How will we obtain physician practice-level data? How will we expand or create those data sets?
  • How will we provide timely, actionable information to providers to support clinical decision making?

Financial management
  • Do we have experience with risk and/or pay-for-performance programs? With bundled payments and episodic payments?
  • Do we have data to estimate performance under alternative payment arrangements?
  • Do we have actuarial support to validate targets?
  • Do we have financial stability to weather new risk/financial arrangements?

More Articles on Accountable Care:

A Strategic Approach to Preparing for Pay-for-Outcomes
ACO Patient Population Attribution: Prospective vs Performance Year Methods
Strategies for Surgical Service Line Success Under Accountable Care

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