The Healthcare Intelligence Hub E-Newsletter
Data / Empowering High Performance
HIMSS11: Getting Down to Business on ACOs
Alan Gilbert, Vice President of Business Development, AxSys Technology Ltd.March 7, 2011
It's been fascinating to watch the trends on the show floor and in the educational sessions at HIMSS over the last few years. Two years ago, the major themes were the Electronic Medical Record (EMR) and Electronic Health Record (EHR), while last year everyone was buzzing about health information exchange (HIE) and healthcare reform.
HIMSS 2011 will perhaps be remembered best for the discussions driven by the Patient Protection and Affordable Care Act (PPACA) and, in particular, its provisions for the creation of accountable care organizations (ACOs) as well as other care collaboration and coordination activities. As Health Data Management reported in its coverage of the conference, Centers for Medicare and Medicaid Services (CMS) head Donald Berwick emphasized his department's vision of ACO as a fresh fee-for-service program and not 'a rehash of a managed care model.'"
Also noted in many ACO-related educational sessions at HIMSS11, including "The New IT Strategy Map" delivered by Dave Garets, FHIMSS Executive Director, and Jim Adams, MBA, Managing Director, both of The Advisory Board, healthcare providers are still "feeling out" what their role will be in an ACO and how IT will support the entire organization. The presentation addressed 12 distinct IT capabilities necessary for the success of ACOs including disease management, HIE and payer integration capabilities.
As Lee B. Sacks, MD, CEO of Advocate Physician Partners, mentioned in his presentation, "Clinical Integration: The Foundation for Accountable Care," effective care coordination and integration strategies offer great opportunity to "bend the cost curve" in the right direction by helping organizations limit potentially avoidable admissions, readmissions and inappropriate emergency department visits - all contributors to the exorbitant healthcare price tag.
Closely related, providers are also wrestling with the idea of who will be part of their accountable care network. Not only must they consider which partners will be the most strategic, but also how they will extend the olive branch to organizations they may currently compete with. Payer organizations will play a significant partnership role in the ACO as well.
As Wayne Pan, MD, PhD, MBA, CMO of Pacific Partners Management Services, noted during his HIMSS11 presentation, "The New American Team Sport: Provider-Payer Integration," healthcare delivery in the coming years will focus on providing value in which everyone has a stake in lowering costs and raising quality. Yet this cannot be achieved without tight integration - clinically, financially and operationally speaking. And while there are some formidable challenges involved with uniting payers and providers, they are finding common ground in activities to create healthier patients through wellness tools, improved access to information, care delivery and billing transparency.
The down side is that there is still a long way to go before the healthcare industry can claim seamless integration. Even large health systems with extensive IT networks will have to extend their technical resources to a wider audience. This will require a major evaluation of their infrastructure, storage capabilities and staffing resources, to name a few. And not to get lost in the shuffle are the applications that truly help coordinate care, lower the cost of care and deliver improved outcomes. After all, isn't that an ACO's ultimate goal?
Alan Gilbert, Vice President of Business Development at AxSys Technology Ltd., chats with Porter Research about the conversations going on at HIMSS revolving around Accountable Care Organizations.
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