ACOs: 3 Tips for Making Them Work

With CMS' recent announcement of 89 new Medicare Accountable Care Organizations, the healthcare world is once again abuzz with talk of ACOs.

Here, Rose Higgins, BSN, MPM, vice president for payor-provider solutions at McKesson, shares three tips for new ACOs to keep in mind as they move ahead with the goal of improving the quality of care while reducing the rising costs of providing it.

1. Utilize enterprise-based analytics. Multiple providers from different healthcare entities are working together in ACOs, and all partners need analytical systems that allow them to aggregate and integrate clinical and financial data across the enterprise. Ms. Higgins says the data must be transformed into actionable insights and presented to stakeholders in a concise and organized way. She says choosing a strategic partner with competence in data acquisition, transformation and presentation is crucial to an ACO's ability to utilize analytics.

"Once data is available, organizations can effectively identify opportunities for improvement and manage the relevant trends going forward," she says.

2. Create strong care management solutions. Analytics are the foundation of any care management plan in an ACO, according to Ms. Higgins. Sound analytic solutions will help ACOs identify patients in a given population who might benefit from what she refers to as a structured intervention. Since improving population health is an important benchmark of any ACO, having care management solutions in place is important to the organization's overall success.

Once an ACO uses analytics to identify patients who need targeted care, those individuals "can be assigned to specific programs where a relationship between the patient and a care manager can be instituted," Ms. Higgins says.

3. Establish sound payment mechanics. While many ACOs still rely on a fee-for-service model to pay providers, new payment tools may be required to manage advanced payment schemes that ACOs are expected to eventually pursue. These schemes may include bundled payments, episode management payments and other alternative payment models that derail from the traditional fee-for-service model.

"As organizations are considering entering into advanced payment arrangements, they will need tools to help them understand the specifics of the arrangement, including analytics to provide them with their historical performance for a specific service line and a perspective on the most efficient providers of those services within their network," Ms. Higgins says.

More Articles on ACOs:

5 Steps to Building a Health Information Exchange in an ACO
Checking in With a Pioneer ACO: Q&A Dr. Tyler Jung of HealthCare Partners
CMS Names 89 New Medicare ACOs

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