Emerging ACO Best Practices for Shared Savings
Only about one-quarter of participants in Medicare’s shared savings accountable care program actually generated shared savings, as did only 12 of 32 original Medicare Pioneer ACO participants; 13 of the original 32 have dropped out. Despite mixed results, there were impressive performances among the successful Pioneer organizations. ACO best practices are emerging, which population health management and analytics vendor Caradigm examines in a recent white paper. (Photo: Fotolia)
Need for Improvement
“The inability to generate shared savings is particularly disappointing because many believed that the shift to preventive, coordinated care would lead not only to healthier populations but reduce the need for higher-cost, episodic care,” according to Caradigm. “Achieving shared savings is a critical milestone for ACOs to demonstrate success in the new reimbursement model, which many believe could become the prevalent model of care in the future.” (Photo: Fotolia)
Starting Blocks for Progress
Many ACOs have not yet truly incorporated innovation into their overall approaches, a necessity to improving results. A key early lesson is that success is driven by core strategies: integrating information systems and leveraging data across the network, stratifying populations to prioritize limited resources so they can have the greatest impact, increasing efforts in targeted care management and primary care for prioritized patients, integrating data and analytics directly into clinical workflows, and centralizing data used for reporting to avoid collection across silos. (Photo: Fotolia)
3-Prong Process
Population health from a technology perspective is about data, analytics and care management operating in an integrated manner and augmenting each other, according to Caradigm. The vendor explains the benefits, noting the best practices “are taken from publicly available materials, examined from a technology-agnostic point of view.” (Photo: Fotolia)
Data Control
Organizations with an integrated network aggregating and sharing all data can have a single source of truth to aid quality improvement; predictive analytics to make the data more effective; a single longitudinal view of patients across the network; and ability to efficiently report on data and identify and close gaps.
Predictive Analytics
Applying predictive analytics to a complete and near real-time data source gives the ability to deeply stratify risk of a population, accurately predict cost savings potential of patients receiving interventions, focus limited resources on patients with greatest return on intervention including patient motivation, and predict which patients mostly likely will become the highest cost patients to proactive improve their health. (Photo: Fotolia)
Care Management I
Information from data and analytics can create care management efficiencies to improve outcomes quicker. Care plans, task lists and interventions are automatically generated from assessment responses to get the highest risk patients to a better place faster. Complete medication histories can be put into single-patient views that display order history and fill history for easy review. High-risk patients can be tracked through events-based alerts, such as admissions, discharges or Bluetooth device alerts. (Photo: Fotolia)
Care Management II
Use of information from data and analytics also means care managers can see longitudinal data and patient responses over time to identify subtle changes and incorporate them in personalized goals, reallocate patient workloads or specific tasks to other care managers or support staff, and identify best practices of care managers and share the practices across the team. (Photo: Fotolia)
Want More?
The Caradigm white paper, “ACO Best Practices for Shared Savings,” is available here. (Photo: Fotolia)