Atrius Health in Newton, Mass., which has functioned like an accountable care organization for several decades, offered some pointers on ACO operations in a report in the Wall Street Journal.
An alliance of five medical groups with more than 800 physicians, Atrius Health saved $62 million in 2010 from ACO-like improvements that lowered costs. In addition to using electronic medical records, case managers and pharmacists who identify drug interactions and possible savings, the system identified the following measures:
1. Efficiency committee. A committee of physicians and staff review operations for new, easy-to-improve efficiency. For example, after noting it took 10 minutes to turn over MRI exam rooms, the committee ordered adjustments like removing cabinet doors so technicians could quickly reach supplies. This cut turnover time in half, allowing for two more MRI patients a day and $3.5 million in savings last year from this improvement alone.
2. Physicians’ chart discussions. Two years ago, physicians started meeting monthly to discuss each other’s patient records. This helped low-performing physicians and improved the quality of care across the organization.
3. Process of care measures. Such measures are showing improvements. For example, the number of patients receiving cholesterol screenings rose from 80-88 percent and the number of diabetics getting a certain blood test rose from 68-79 percent.
But Atrius Health officials admitted the ACO model might pose difficulties for smaller organizations than their own. For example, some fee-for-service payments do not cover the cost of care coordinators for patients, forcing Atrius Health to cover the costs by reaching into global payments from other insurers.
Also, some hospitals do not cooperate with Atrius Health on its goal of reducing admissions. Other hospitals, however, do cooperate: Atrius Health saved roughly $5 million from its hospital partnerships in 2010.
Read the Wall Street Journal report on ACOs.
Read other recent coverage of ACOs:
– ACOs May Create 3-Year Loss Before Savings Kick In
