What does it take to create an accountable care organization that meets benchmarks in care delivery and proves to be profitable?
Jeff James, Chief Executive Officer at North Carolina-based Wilmington Health, says metrics and analytics allow for his group’s ACO to exist.
The ACO was formed as a partnership with Blue Cross Blue Shield of North Carolina. It’s that state’s first commercial ACO. And, it is hitting benchmarks for readmission rates, admissions and ER visits.
James says without the information provided by metrics and analytics, the ACO would never be able to succeed.
He says the tools give the ACO the ability to measure, report, and share both their successes and opportunities for improvement.
“We would never be able to measure our quality. We would never be able to report it transparently to our partners or our providers,” says James. “And we would never be able to show our patients what we’ve accomplished and what we can accomplish for them.”
James shares additional lessons learned in a #5in5 video. In five minutes, he explains how Wilmington had to adjust its relationship with BCBSNC and how utilization has changed. He also offers his most important advice for any organization implementing an ACO.
If you have more time to explore this topic, you can also view a 60-minute webinar: Analytics in Action.
Read more about ACO collaborations and the potential for these collaborations to cut costs and increase market share in the Optum white paper A Model for Value-Based Provider/Payer Partnerships.
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.