Even the most practiced at population health management may struggle with one factor deemed by many to be crucial for success as an accountable care organization or ACO.
The challenge? Implementing a health IT infrastructure and data analytics strategy.
Health IT Analytics lists analytics as a defining capability of successful ACOs. It reports that a robust analytics platform provides the kind of information needed to coordinate care, predict risk, manage chronic diseases and make clinical decisions – all important for payment models based on value rather than volume.
Health IT Analytics also explains knowing how to utilize data is not an easy skill to acquire. It points to a report from the eHealth Initiative and Premier, Inc. which shows organizations find particular difficulty consolidating data from varied sources, accessing it in a timely manner and analyzing it.
The Optum white paper The speed of transformation: Preparing for the payment models of tomorrow, explains this challenge even troubles organizations and providers already experienced in coordinating care for patients – like those that qualified for the Centers for Medicare and Medicaid Service’s (CMS) Pioneer ACO program.
The paper says L&M Policy Research analysts found that many of the Pioneers “have not yet fully optimized… core aspects of the accountable care model.” That includes information management and IT systems.
Healthcare organizations and providers that have cleared the analytics hurdle describe data as key to ACO progress.
Emilio Dominguez, MD is the chief medical officer for the multispecialty group Florida Medical Clinic – one of more than 400 ACOs participating in another CMS program, Medicare’s Shared Savings Program (MSSP).
- See where ACO members of MSSP are located.– Healthcare Finance News
“The accountable care organization may best be called a work in progress,” Dominguez explains in an Optum Provider 5in5 interview.
He says what is working for the group is data.
“The analytics platform we chose has really been an important part of helping us get to where we needed to be with not only our accountable care organization but also with several value-based contracts we have,” says Dominguez.
Analytics are also part of the ACO strategy at Memorial Hermann ACO, one of 2014’s top-performing MSSPs, according to the Healthcare Intelligence Network. The ACO uses a data warehouse to find at-risk patients and get them the appropriate care. The ACO saved the MSSP nearly $53 million in 2014 earning a payout of almost $23 million, according to HIN.
Clearing the hurdles
There may be ways to increase the chances of achieving that kind of success.
Education and research firm TDWI asked data executives across industries how they tackle the challenges of implementing advanced analytics – issues like a lack of skilled personnel, technological knowledge, and money or executive support.
TDWI reports firms are hiring new personnel, training workers, and bringing in outside consultants. They are attending webinars and meeting with vendors. They are also looking for executives to champion analytics or trying to generate excitement through proof of concept or pilot programs.
You can learn more about the link between analytics and a successful transition to an accountable care organization. Dr. Dominguez answers five questions in five minutes in the #5in5 Using analytics platform to reach ACO goals. He explains how an analytics platform is changing the way Florida Medical Clinic does business.
About the author
Karen Thomas-Smith is vice president of Provider Marketing & Reference Management at Optum. She brings to the role more than 15 years of global experience in the software industry. Karen has shared her unique ideas on corporate culture and leadership in a number of television appearances on Oprah, 60 Minutes and Canada Public Television. Prior to her position at Optum, Karen spent time at Allscripts and SAS.
She holds a bachelor of science degree in business administration from North Carolina Wesleyan College, graduating Magna Cum Laude.