Providing ACO Clarity

By Ken Congdon, editor in chief, Health IT Outcomes

Accountable Care Organizations (ACOs) have been lauded as having the power to save our healthcare system from almost certain economic doom. This healthcare delivery and payment model makes an entire network of doctors, hospitals, and ancillary providers jointly responsible for the ongoing care of patients. Furthermore, it reimburses this network based on overall patient outcomes as opposed to reimbursing providers for individual services provided. However, much is unknown about exactly how to structure an ACO or how providers will be reimbursed within the ACO model. Moreover, much of what is known — namely the CMS ACO requirements proposed in March of this year — have not been received with open arms by the healthcare community at large. To the contrary, these rules have many providers running for the proverbial hills. In fact, Henry Ford Health System, an IDN widely recognized as an ACO pioneer (and a contributor to two ACO articles in this newsletter), withdrew its application to be part of the CMS ACO Pioneer program largely due to the ambiguous nature of the CMS requirements and reimbursement uncertainties.

While most providers would agree that the CMS ACO rules are in need of major modifications, many would also admit that the ACO concept , in and of itself, has merit. This is why, in spite of the questionable CMS rules, many providers, including Henry Ford Health System, are still moving forward with ACO initiatives. Now more than ever, healthcare providers need useful and actionable information on existing ACO strategies, challenges, and successes. Health IT Outcomes is dedicated to providing you with the information you seek. We will regularly be interviewing healthcare providers of all sizes about their current ACO initiatives and their future ACO plans. We will keep you informed of the latest ACO developments and trends, so you can develop or modify your own ACO game plans.

To illustrate our dedication to being your single source for ACO knowledge, we’ve compiled several of our most recent ACO articles in this newsletter. For example in Making The Move To ACOs, we highlight the paths Henry Ford Health System, Marquette General Health System, and Concord Hospital are taking to achieve accountable care. ACOs: What The Henry Ford Physician Network Can Teach You takes a closer look at the advantages of taking a physician-led approach to clinical integration and accountable care. Lastly, The Role Of IT In ACOs examines why a flexible health IT infrastructure is vital to the long-term sustainability of any ACO.

In addition to these and other educational articles, case studies, and white papers on ACOs, you can also leverage our website www.healthitoutcomes.com to search for the latest technology solutions that will be instrumental in building the underlying IT infrastructure of your ACO. For example, searches for EHR, HIE, e-prescribing, and business intelligence can quickly provide you with a comprehensive list of several solutions available on the market and help you evaluate your options.