5 Ways to Put People First in an ACO

In healthcare, we require appointments for test results, even though we could relay them privately over phone or email. We recommend preventive care, but we don’t follow up to ensure the appointment is made or arrange transportation help. We limit office hours to be convenient for the provider, not for the people who need care. In general, we put provider needs ahead of those who need our services — something no other industry would dream possible.

By moving toward accountable care, we can change this dynamic. Based on lessons learned from the Accountable Care Implementation Collaborative, the Premier healthcare alliance has developed five steps to putting people first in healthcare.

1. Involve people in decisions. First and foremost, providers should not think not in terms of “patients,” but in terms of “people” to keep the focus on the needs of all individuals in the community — whether they have accessed care (“patients”) or are part of a health plan (“beneficiary”). The choice is important. It highlights how ACOs are accountable for the population, including those who have not sought care.

To increase engagement, people should be empowered to understand their options and make informed decisions about their health. A best practice for involving people in care comes from Billings Clinic. At Billings, diabetics are given a scorecard recommending all the measures that must be tracked to keep the condition in check. This scorecard is kept on file at Billings, and provided to the individual so both are accountable. In this way, Billings gives people tools to ask for the care they need, rather relying on providers to tell them what to do.

2. Improve access. Without access to care after hours, people seek care from the only available places — emergency departments or other expensive, inconvenient settings. Rather than providing services during the hours providers want to work, we need to provide care 24/7.

This starts with scheduling. Physician practices should consider open access or same-day scheduling to ensure people can be cared for before conditions worsen. These can be group appointments with people who share a chronic condition, or systems that leverage physician assistants and nurse practitioners. Similarly, providers should explore new care technologies, such as those leveraged by Fairview Health Services, which allows people to be diagnosed via phone or Web camera.

3. Taking responsibility. Many 40 year-old women get mammogram reminders. But the measure of success shouldn’t be the number of reminders mailed, it’s the number of women who get the test.

One way to make people accountable partners for their health is through personal health records, which contain records as well as care and wellness options. With a PHR, people can access lab test results, prescriptions and care plans, as well as input information on appointments made or weight or blood glucose levels. With a record, people can see what’s been done and track it against their care plan.

Other strategies include insurance benefit design to encourage healthy choices. Health Partners, an insurer, offers lower premiums, co-pays and deductibles for people who participate in wellness programs. Similarly, Marriott offers reduced co-pays for medications treating high blood pressure, diabetes and high cholesterol.

4. Address individual needs. Today, providers may not being able to control unhealthy eating habits. But they can expand their influence if they understand individual needs and challenges. People struggling with weight may have challenges that lead them to unhealthy choices, including access to money, healthy foods, safe walking environments, knowledge about healthier lifestyles or even depression. Once the need is known, providers can coordinate and connect people to services that keep them healthy.

But, with so many elements of a people-centered paradigm, it must be personal to target individual needs. A good example is the Health Risk Appraisal from the University of Michigan. This questionnaire provides a health assessment based on lifestyle choices. It recommends behavior changes for each individual’s top three personal health risks based on age, gender and risk level, as well as resources for addressing each.

5. Measure and improve the experience. ACOs striving to improve the care experience need to measure opinions and implement processes for improvements.

ACOs should select measures, such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) or the Patient Activation Measures (PAM), and survey people via mail, online, in person and phone. Once collected, providers should review data, trend results and develop improvement plans. To build trust, results should be publicly disclosed — both positive and negative — with clear plans for improving the experience.   

In healthcare today, provider convenience is often put ahead of people seeking care. But, we live in an on-demand world for shopping, banking, entertainment and information, and every other sector of the economy caters to individual needs. It’s time for healthcare — our most personal service — to follow suit. 

Learn more about Premier Consulting Solutions.

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