ACO Governance: Align Functions of the Operations Team to a Common Goal

This post is the second of an 11-part series that proposes structures and actions that characterize successful accountable care organizations.

As mentioned in the previous blog post , the operational leadership team of an ACO should be comprised of senior-level leaders who have the authority and accountability to make and implement changes to day-to-day operations. These key functional offices should be driven by tactical teams that report to the operational leadership team:

Cynthia Kilroy

  • The strategic importance of the ACO Project Management Office (PMO) should not be overlooked; it coordinates and communicates across all functional offices. PMO team members work with subject matter experts to identify initiatives that meet overall partnership goals. The PMO manages scope, implements changes and measures success. It is accountable to the executive team and operational team and is responsible for reporting projected and actual budgets and financial performance.
  • Office of Finance is accountable to the board and the senior operational team for the development and approval of the shared-risk contracts and cost reduction measurements. (Cost reduction measurements should be validated by actuarial experts to ensure understanding of medical trend impacts.)
  • Office of Clinical Transformation aligns with the physician leadership team and is responsible for identifying and delivering clinical savings opportunities, including practice redesign, hospital service line design, population health management and continuity of care. This office must be led by clinical experts, including physicians, nurses, care managers, behavioral specialists and social workers.
  •  Office of Marketing and Member Engagement is accountable for the crossorganizational marketing strategies for member enrollment and engagement and for product and benefit design.
  • Office of Analytics mainly supports the clinical transformation initiatives in developing information to evaluate opportunities, validate saving targets and measure the results for each initiative.
  • Office of Technology is responsible for driving the overall IT strategy to leverage current systems and capital investment, while ensuring information sharing across the continuum of care.
  • Office of Physician Alignment works closely with the physician leadership team and is accountable for engaging with the entire network to communicate upcoming changes, educate on new policies and obtain feedback on progress/challenges.

The next post in the series will describe the critical role physicians need to play in utilization management.

Resources:

Cynthia Kilroy, Sr. Vice President, Provider Strategic Initiatives, Optum

5 thoughts on “ACO Governance: Align Functions of the Operations Team to a Common Goal

  1. Pingback: Benchmarking Clinical, Financial Goals Key for ACO Performance and Care Delivery | Healthcare Exchange

  2. Pingback: Empowering patients to support population health initiatives | Healthcare Exchange

  3. Pingback: Improving overall population health starts at better care for individuals | Healthcare Exchange

  4. Pingback: Leveraging technology to support the sharing of information and drive decision making | Healthcare Exchange

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