Accountable care

The accountable care organization (ACO) model faces a pivotal moment, and its success or failure depends on what the federal government does next, argues a new white paper from the National Association of ACOs (NAACOS).

More than 50 attendees spent two days here learning how the power of data, better use of staff, and advances like telehealth can free up primary care physicians (PCPs) for their core mission: spending more time with patients whose complex conditions put them at risk for driving up healthcare costs. The ACO and Emerging Healthcare Coalition, a multistakeholder initiative of The American Journal of Managed Care, held its second live meeting October 16-17, 2014, at the Miami Marriott Biscayne Bay.

The Centers for Medicare and Medicaid Services (CMS) recently released more detailed ACO-level data for participants in first two years of the Pioneer ACO Model. The program, which is designed for health systems with more experience assuming financial risk for patient populations, has generated savings and improvements in quality measures, but has also struggled to retain participants. The program began with 32 provider organizations; following a series of recent announcements there are now 19 total participants.

The financial burden of health information exchange (HIE) and the difficulty of wrangling multiple vendors into some sense of interoperability are among the top challenges facing the national health IT infrastructure and the shift towards population health management, according to the eHealth Initiative’s 2014 survey.  While Stage 2 of meaningful use has pushed the industry towards wider adoption of Direct messaging and registry reporting, providers have a long road to travel before data exchange becomes simple and seamless across the care continuum.

The ability of accountable care organizations to meet the goals of improving care and lowering costs may be hindered by health IT obstacles suggests a new analysis.

Of the 62 ACOs polled by Premier healthcare alliance this past summer, 88 percent report "significant obstacles" in integrating data from disparate sources; 83 percent say they have a hard time fitting analytics tools into their workflow; and 90 percent say IT costs and a lack of return on investment are key roadblocks to more effective implementation of health IT.

Universal American Corp. (NYSE:UAM) announced today that the Accountable Care Organizations (ACOs) it formed in partnership with primary care physicians generated $57 million in total program savings for the Centers for Medicare & Medicaid Services (CMS) as part of the Medicare Shared Savings Program for program years 2012 and 2013.

Many accountable care organizations are struggling with advanced IT functions and interoperability, a survey of 62 ACOs conducted in July and August 2014 by Premier and the eHealth Initiative shows.

“Most ACOs are still at the stage of basic care-coordination capabilities,” said Bryan Bowles, Premier's vice president of population health solution management, Wednesday on a call discussing the survey. “The challenges of blending disparate data have hindered uptake of more advanced functions.”

The CMS for the first time publicly released individual performance data for Medicare accountable care organizations on 33 measures of healthcare quality. 

The results for 220 of the participants (PDF) in the Medicare Shared Savings Program reveal how ACOs performed on measures (PDF) of patient experience and preventive care and disease management for some of the leading causes of death among U.S. elderly, including heart disease, cancer and diabetes. 

Phoenix obstetrician Megan Cheney no longer makes hours of telephone calls on Thursday nights to report routine results of laboratory tests to waiting patients. The calls, however, still get made every week.