By Tom Alexander
As healthcare payers, providers, patients and thought leaders consider ways to reduce the cost of care and improve outcomes, accountable care organizations (ACOs) have emerged as a viable model to achieve those goals. In an ACO, healthcare providers voluntarily join together to coordinate services and adopt population health strategies and value-based payment models. That increased coordination requires more sophisticated data collection and management. The need for systems to handle that has led to companies like The Garage and others, which help ACOs establish and implement the technological framework needed to support and manage value-based care (VBC).
An analysis published in 2020 in the journal Health Affairs looked at multiple studies of Medicare spending since ACOs were established in 2012 and concluded that ACOs are lowering Medicare spending by 1-2% annually. A 2% reduction in spending would save nearly $200 billion when compounded over a decade. The analysis also looked at Centers for Medicare and Medicaid Services Public Use Files and found that ACOs received an average quality score of more than 94% for the most recent year that data are available.
Initially, most ACOs served Medicare and Medicaid beneficiaries. With more data showing that VBC can reduce healthcare spending and improve patient outcomes, more healthcare providers are shifting to this model. In recent years, the number of ACOs working with private insurance has risen. In fact, as of the third quarter of 2019, ACOs were responsible for nearly 44 million lives in the U.S. As more healthcare providers begin to shift to VBC models, ACOs can blaze the trail to show the entire industry how best to shift the paradigm, saving lives and money.
Here are a few ways ACOs can do that:
Break Free from Siloed Thinking
Managing any paradigm shift must begin with a shift in mindset. Healthcare providers have traditionally operated in silos, working independently and without visibility into what others were doing. As such, providers rarely shared patient information. Population health management requires cooperation among every provider in the organization and a sharing of patient data in order to coordinate care and look at the patient’s overall health, including social factors and comorbidities that can affect clinical and financial outcomes.
Adopting population health management is all about data. Each provider in the organization needs access to overall patient data to coordinate therapies and monitor patient outcomes. An ACO must create and maintain a network for sharing patient data, including medical history, supporting referrals from doctor to doctor and more. In most cases, that means the organization needs to find a technology-based solution to smooth the exchange of those data. While many ACOs are often quick to adopt a population health management tool, the systems are only as good as the data entered into them. They require active users such as healthcare providers and their staff continuously providing up-to-date patient data in order for them to work as designed and coordinate patient care. The more active the users, the better the system works. That means coordination of possibly thousands of providers, and all their staff, who now need to move from the way they have been doing things for years (which likely included a lot of repetitive and even incomplete paperwork) to a new way of recording, sharing and evaluating information. In many cases, that’s a change in the way providers in the organization have worked in the past, which requires buy-in from everyone in the organization, from administrative staff to senior leadership.
One effective way to achieve that kind of buy-in is to create a goal-oriented roadmap of the organization’s needs. It’s important to identify clear clinical and financial objectives and find a technology partner that will work with the organization to set and meet those objectives. Without firm objectives, an ACO’s members won’t see how they are addressing the larger VBC goal or understand their role in making it happen.
Another way to achieve organizational buy-in is through training. It’s important for ACOs to find a population health technology partner that provides user training and ongoing support, in order to ensure that the organization is achieving the best possible outcome from utilizing the tools, including keeping users in the habit of updating the data in the system and teaching them the necessary skills to access and utilize those data. It’s also incumbent upon organization leadership to make sure that the time ACO members spend training to use a population health management tool is valuable. The better the members and providers learn to use the system, the more they can improve overall patient health and outcomes, in addition to saving money and time.
Find the Right Technological Solution
While there are many vendors offering technology-based tools for population health management, finding the right tool for the organization’s needs is paramount. Some systems can't share data with other platforms, which can make it difficult for ACOs to monitor where and when patients receive care and what care they receive to keep tabs on quality and costs.
It's important to find the right technology “under the hood” to meet the ACO’s needs. Advanced technology such as artificial intelligence and machine learning, HIPAA-compliant cloud-based solutions, intuitive human-machine interfaces and mobile technology are all valuable tools for population health management and value-based medicine. Intelligent, highly automated population health management platforms can provide greater transparency into the healthcare ecosystem by easing access to relevant knowledge. These solutions enable smooth data sharing between providers, ancillary organizations and other IT vendors to create a complete and fully collaborative medical record.
Once it chooses a technological solution for population health management, the longer an organization waits to get that system up on its feet, the longer it continues doing things the “old way.” Many companies can take months to get a population health management tool on its feet and get ACO members trained. The sooner an organization adopts its new workflow and technology, the sooner it can begin saving time and money, while improving long-term patient health.
In addition, ACOs should search for a partner that offers ongoing training and support to keep things running efficiently, as well as solve for new challenges and opportunities that may arise after implementation of the technology. ACOs are still relatively new to healthcare, and their impact is being measured and evaluated all the time, especially as it pertains to achieving the Triple Aim. ACOs should be flexible enough to adopt new systems quickly and move organizational goal posts as needed when they evaluate the efficiency of a population health management tool. An ACO’s technology partner should also be nimble and efficient, in order to adjust to the ACO’s changing needs.
Additionally, while standardized models of patient care have become increasingly common to ensure consistency of care, it's important for organizations using population health management strategies to be nimble when it comes to creating patient care plans. Standardized models can be valuable for patients who fall within common parameters, but every organization must generate processes and implement tools that can identify and respond to exceptions to those parameters.
This also applies to operations. While population management and value-based care models can increase efficiency, organizations must be willing to change course when analysis of operational data shows that further efficiencies can be implemented, in order to deliver more precise and accurate care.
By remembering these important considerations, an ACO can help pave the way for the entire healthcare industry to see the power of VBC and begin adopting this model. Choosing the right partner is an important part of this process. ACO’s should look for a technology partner that can (1) train and support ACO members, (2) can help clarify and meet organizational objectives, and (3) get the system up and running rapidly.
The Garage and its Bridge platform meet all of those requirements. Bridge is a collaborative population health management platform where providers, care managers, physicians and patients collaborate more effectively for improved patient care and lower costs. This SaaS-based platform connects providers and enables easy, seamless and secure exchange of patient information. Bridge’s key features include quality measures tracking, wellness management, provider education, preventive health screening and monitoring, administrative reports, clinical patterns, revenue optimization and operational analytics. It also includes health risk assessments and stratification, transitions of care and follow up, care plan definition, management and tracking.
Here’s how The Garage and Bridge can be the perfect partner for ACOs:
VBC and population health management are changing the future of healthcare, and technology is an important component of that, from changing the way healthcare organizations think about data and patient care, to being nimble and measuring efficiency. However, it’s important to consider that the technology is meant to augment value-based medicine. The human element of patient care is still important.
Population health management looks at the entire patient and all the elements that factor into overall health. That means the humans who collect the needed health and demographic data at the point of care are a vital component of creating a customized care plan for each patient.