OIG: Health IT brings both benefits, challenges to Medicare ACOs
Medicare accountable care organizations were able to better coordinate patient care thanks to their use of health information technology tools.
The HHS Office of Inspector General conducted onsite interviews at six Medicare ACOs—four were Next Generation ACOs and two participated in the Medicare Shared Savings Program—that included discussions with administrative staff and providers.
“ACOs that used a single electronic health record system across their provider networks were able to share data in real time,” states the OIG’s report. “A small number of ACOs had access to robust health information exchanges, which gave ACOs access to patient data even when patients saw providers outside the ACOs’ networks. Most of the ACOs we visited use data analytics to inform their care coordination by identifying and grouping patients according to the potential severity and cost of their health conditions.”
While the OIG concluded that the ACOs “have used health IT to aid in care coordination in a variety of ways,” auditors also noted that the full potential of HIT has not yet been realized.
“ACOs vary in the extent to which they can rely on health IT tools,” according to the report. “The Department of Health and Human Services has promoted the use of these tools for the promise they hold to help patients achieve better outcomes at lower costs. This work showcases some of the advances ACOs have made as well as challenges that remain for fulfilling that promise.”
Among the challenges for ACOs highlighted in the OIG's report:
- ACOs using multiple EHR systems had to rely on other means to share data between providers, such as phone calls and faxes.
- The organizations faced challenges from physician burnout because of the workload of managing EHRs.
- Most of the ACOs had access to HIEs with little or incomplete data, making it difficult to coordinate care when patients saw providers outside the ACOs’ networks.
- Few of the ACOs use analytics to customize care to an individual patient's needs.