Technology expertise key for ACO growth

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.”