Tech­nol­ogy ex­per­tise key for ACO growth

Modern Healthcare - - BY THE NUMBERS - By Michael San­dler

The es­ti­mated num­ber of Amer­i­cans cov­ered by ac­count­able care or­ga­ni­za­tions shot up 30.7% be­tween 2014 and 2015, while the to­tal num­ber of ACOs ticked up only slightly from 726 to 738, ac­cord­ing to Mod­ern Healthcare’s an­nual list of ACOs by state.

Cal­i­for­nia topped the list, with 78 ACOs at the end of June. Florida came in sec­ond with 72. Af­ter that, there was a con­sid­er­able drop-off in the num­ber of ACOs among the states.

But ACO cov­er­age pen­e­tra­tion in terms of cov­ered lives in each state presents a dif­fer­ent pic­ture, said Erik Krisle, se­nior an­a­lyst at Leav­itt Part­ners Cen­ter for Ac­count­able Care In­tel­li­gence, the Salt Lake City­based firm that pro­vided the data. For in­stance, Maine, which was tied for 26th with 14 ACOs, has the high­est es­ti­mated ACO pen­e­tra­tion rate.

While ACOs are grow­ing, provider or­ga­ni­za­tions face chal­lenges as they try to de­velop and ex­pand these val­ue­based de­liv­ery mod­els, ex­perts say. Health in­for­ma­tion­tech­nol­ogy in­ter­con­nect­ed­ness is a ma­jor is­sue, said David Muh­lestein, Leav­itt Part­ners’ se­nior di­rec­tor of re­search and de­vel­op­ment.

Some ACOs have elec­tronic health-record sys­tems that com­mu­ni­cate well with each other and can track where care is de­liv­ered, he said. But some ACOs have dozens of EHRs among their par­tic­i­pat­ing groups, and they of­ten are not in­ter­op­er­a­ble. It can take up to three years to de­velop a co­he­sive EHR sys­tem, Muh­lestein said.

He noted that an ACO’s health IT plat­form should have func­tion­al­i­ties for pop­u­la­tion-health man­age­ment, along with staff trained in how to use these tools to co­or­di­nate care and keep pa­tients healthy. Doc­tors of­ten don’t have time to learn how to use the tools and per­form pop­u­la­tion­based analy­ses. That means nurses and care man­agers must be able to use the plat­form. In­ter­op­er­abil­ity is a good start. “That’s the en­trance to get in the race,” Muh­lestein said. “But it doesn’t mean you’ll win the race.”

ACO lead­ers should keep their eyes on emerg­ing tech­nol­ogy trends, said Dr. Bob Wil­liams, na­tional med­i­cal leader for Deloitte’s life sciences and healthcare con­sult­ing prac­tice.

Find­ing ways to en­gage pa­tients and their fam­i­lies in bet­ter man­ag­ing their health, in­clud­ing tex­ting with provider or­ga­ni­za­tions, online pa­tient por­tals and re­mote mon­i­tor­ing will be im­por­tant for ACOs, Wil­liams said.

But hav­ing ro­bust care pro­cesses and trained staff car­ry­ing out those pro­cesses is crit­i­cal, he added. “Tech­nol­ogy is key, but it is a tool.”

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