Tuesday, March 15, 2011

A.C.O. More on

 

Ken Cohn, wrote to me today about ACOs. Ken Cohn describes multiple issues and complete ambiguity regarding how to form or implement an ACO.

Here is what he  wrote to me.

“Dear Gary,

I participated in a panel discussion of physicians' roles in Accountable Care Organizations two weeks ago.  The blog post that summarized the discussion resulted in a firestorm of comments.  When you would like to learn more about ways that you can engage physicians to improve healthcare collaboration, please read on.

Doug Hastings, a lawyer and Chairman of Epstein, Becker, Green, empathized with the difficulties that healthcare leaders face, planning for an uncertain future in the absence of specific regulations regarding Accountable Care Organizations (ACOs).  When he summarized the 2011 National Committee for Quality Assurance (NCQA) draft guidelines, he mentioned the following overriding concepts related to ACO formation and operation:

  • ACOs must include a group of physicians with a strong primary care base and sufficient other specialties that support the core needs of a defined population of patients.
  • Performance measurement across the triple aim domains of cost, quality and patient experience must be a key element in the evaluation of ACOs.
  • ACOs must facilitate timely information exchange between primary care, specialty care, and hospitals for care coordination and transitions (NCQA 2011 ACO Criteria and Implications for ACO governance. BNA's Health Law Reporter, 19PVLR1573)

    Jeff Petry, VP of Business Development at Premier, said that the 3 R's of ACOs include:

    • Regulations
    • Reimbursement
    • Relationships 

    Possible roles for physician champions in ACOs include:

    • Presenting and discussing clinical data with fellow physicians
    • Minimizing physician-hospital battles
    • Creating a safe environment for learning
    • Helping to build transparency and trust

    The above strategies and tactics have worked in hospitals in 40 states where I have worked.  What is working for you where you work?”

    He did not mention specific hospitals

    Mr. Cohn then goes on to discuss building relationships and possible roles for physician champions, suggesting some of the following:

    Possible roles for physician champions in ACOs include:

    • Presenting and discussing clinical data with fellow physicians
    • Minimizing physician-hospital battles
    • Creating a safe environment for learning
    • Helping to build transparency and trust

    Physician Champions  Collaborative Listening  

    Observations:

    EMR, and HIE are works in progress

    ACO….the foundation has yet to be excavated..

    The cart is definitely in front of the horse(s)

     

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