Measuring ACO Care Quality Starts With Existing Data, Resources and Tools

Understandably, the need for clearly defined accountable care organization clinical outcomes criteria has led to industry-wide interpretation. But while stakeholder interest lies in shared savings and aligned incentives, ACOs above all must be about creating a consortium focused on improving the patient care quality of its designated population.

So, as organizations strive to create an ACO that makes quality the upmost priority, less apparent are the financial strategies — for example, understanding the ACO's business problems including quality reporting and its correlation to better care. Analytics, a fundamental building block of the ACO, can help the consortium administer this task and, at the same time, evolve it toward better treatment for patients. For that reason, health information will be a universal requirement driving quality, efficient and accountable care.

Since care quality measures will be the barometer for success, how do stakeholders actually measure that quality? How does one know if the ACO is achieving the expected quality and cost improvements? Should organizations forge ahead investing in expensive new data sets, tools, system upgrades, labor, and massive data mining and warehousing? The definitive answer is not likely. The key is to extract the right data points to track and measure against care quality goals. What's more, abundant data, while not easily visible, is, in fact, accessible and usable to all today.

Because goals and budgets change continuously in healthcare, so, too, will ACO development priorities. Getting a grip on your ACO's business challenges, though presently nebulous, and the clinical data indicators in place and their evolvement will significantly help maintain holistic focus on targets of measurable quality to achieve the desired enhanced care, outcomes and value. Amid competing IT projects and budget priorities, adopting a mindset of leveraging existing resources, assets and technologies is recommended for ACO success.

Eric Mueller serves as services president at WPC, a full-service healthcare technology and business process consulting organization in Brentwood, Tenn. His 20 years of diversified experience spans healthcare IT strategic planning and execution, revenue cycle optimization, security and compliance, new product and technology launch, organizational design and re-structuring, P&L management and mergers and acquisitions.  

More Articles on ACOs:

15 New CMS Medicare ACOs to Participate in Advance Payment Model
CMS Names 89 New Medicare ACOs
Cigna Launches New ACO With Denver Physician Group

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