Designed to improve the coordination and quality of care and lower costs for Medicare patients, ACOs are considered an important step in the effort to move Medicare – and ultimately the entire health care system – toward a value-based reimbursement model. They are a major component of health care reform.
To be sustainable, a recent report from IDC Health Insights argues, ACOs must focus on clinical improvements through the use of expanded data sources, improved analytics, more personalized care plans, and effective patient engagement. Population health management applications, IDC notes, enable the first step toward sustainable accountable care.
For Lehigh Valley Health Network in eastern Pennsylvania, the decision to form an ACO was a logical choice. With an aging population, a reputation for quality, and an established care coordination infrastructure, Lehigh Valley was well positioned to become one of 89 new ACOs to join the Medicare Shared Savings Program in 2015.
Lehigh Valley also has the key ingredient for sustainability identified by IDC – a strong data and analytics infrastructure. This infrastructure enables the organization to track and proactively reach out patients in need of care, gauge and improve the effectiveness of care, and truly take accountability for its patient population.
So far, the results have been positive, according to Dr. Nina Taggart, physician administrator for population health at Lehigh Valley. Though challenges remain, Taggart says the Lehigh Valley ACO has seen decreases in in-patient stays, emergency room visits, ambulatory care sensitive conditions, and changes in end-stage renal disease. While this may be the low-hanging fruit of the health care system, it’s a significant step in the journey to value-based care.
More importantly, Taggart says in the latest 5in5 video from Optum, the success of the ACO has created momentum for a wider conversation about population health management throughout the network. What the Lehigh Valley ACO is doing with its Medicare patients, she says, spreads across most of the organization’s patient populations. Although not all patient populations are created equal, there is hope that the lessons learned from the ACO can be applied elsewhere.
Click here to watch a 5-minute video. In it, Taggart discusses the lessons Lehigh Valley is learning from its ACO.
About the author
Leslie Cozatt currently serves as Director of Marketing, Optum Provider – Thought Leadership and Content Strategy. She directs the development of content that spotlights the role of data analytics in healthcare – specifically the transition to value-based care, risk management and population health management. She brings to her role more than 20 years of experience developing B2B and B2C integrated marketing campaigns for companies including ThreeWire, Eliance and 3M. Leslie attended the University of Minnesota and graduated from Wellington College with a BS in International Business & Communication.