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Mostashari: MU is a road map for improving care, not a distraction
National HIT Coordinator Dr. Farzad Mostashari asked providers at the National Health IT and Delivery System Transformation Summit not to view meaningful use as a distraction, but as a road map for achieving better care at lower costs. "If it's a distraction, we need to change it and I want to hear from you personally," he told conference attendees.
Accountable Care On the Rise
ACO's on the Horizon. Accountable Care Organizations, or ACOs, are new care delivery models covered in the Patient Protection and Affordable Care Act passed by Congress and signed into law by President Obama in March 2010. Whitepaper: Accountable Care Organizations and Beyond: IT Strategies for 21st Century Healthcare
The law provides:
Funding for demonstration projects to develop, implement and test ACO models, which include patient-centered medical homes, primary care physicians, specialists, minimum of one hospital, ancillary providers a minimum of 5,000 Medicare beneficiaries (for Medicare demonstration funding),
Care coordination ability and mechanisms to support payer partnerships with reimbursement based on quality, efficiencies and patient satisfaction. ACOs are paid based on the population they serve rather than on a fee for service basis, and their reimbursement can be raised or lowered based on performance.
Funding for demonstration projects to develop, implement and test ACO models, which include patient-centered medical homes, primary care physicians, specialists, minimum of one hospital, ancillary providers a minimum of 5,000 Medicare beneficiaries (for Medicare demonstration funding),
Care coordination ability and mechanisms to support payer partnerships with reimbursement based on quality, efficiencies and patient satisfaction. ACOs are paid based on the population they serve rather than on a fee for service basis, and their reimbursement can be raised or lowered based on performance.
Former CMS chief points to urgency of moving to ACOs
Former CMS Administrator Dr. Mark McClellan said now is the time to make the shift from fee-for-service models to accountable care organizations, especially as the industry faces an increased urgency to improve care and reduce costs. "ACOs are not going to be an immediate solution to all [U.S. health care] problems, but neither is anything else," he said at the National Health IT and Delivery System Transformation Summit.
Interview: Todd Cozzens is CEO of the Accountable Care Solutions group of Optum
How is your company approaching that market? Optum is purpose-built for this. The payer part of Optum deals with 1,700 payers, not just United, so they’ve got a huge portfolio of products and services that they enable payers with. On the provider side, with the acquisition of Picis, Executive Health Resources, A-Life Medical, etc. you’ve got big revenue cycle practice, big clinical performance practice, big consulting, one of the largest Epic implementers. Then on the government and policy side with Lewin Group. It’s really been a very strong combination of skills that we’re able to bring to bear into a hospital. These Sustainable Health Communities or ACOs are really being led by health systems. The larger IDNs are now starting to really grasp that this is where they got to go. They’ve got to learn how to adopt a lot of the techniques that payers have used for years. Not just how to analyze my census, but how do I analyze population in the community, and how do my lines of service relate and adapt to that population? Do we have the correct number diabetes experts and doctors and care services? Can we predict what’s going to happen? Are lines of service performing above or below national benchmarks? Are we looking at the patient care more longitudinally rather than transactionally?
As hospitals go from fee-for-service to fee-for-value — which many are doing — they’re going to need a lot of help. That’s not been their core expertise in the past. They’ve been focused on core operations in the hospital and not even that much on the pre-hospital or post-hospital care. But they’re the ones that are leading this new kind of care model. They need to pick up a lot of these skill sets and capabilities to be able to manage risk. That’s what Optum. with all the analytics technology and capability in this area, has been doing for years on the payer side. Enabling Sustainable Health Communities is our core focus. We help clients with the three qualities they need to build them – connected, intelligent, and aligned. We says Sustainable Health Community because a) it’s got to be sustainable, because the current system is unsustainable; b) it’s community-oriented — you’ve got to understand the entire community, not just the patients who are coming into the hospital census. Health is not just about who’s getting sick — it’s about how do you keep people out of the hospital. That’s what we really focus on. In order to do that, we tell hospitals that you’ve got to have these three capabilities. You got to be connected. Your physicians and your hospital and your payers have got to all be connected and looking at the same set of data. That’s what happens when businesses vertically integrate — they get connected. They’re going to be aligned and incentives align in how you’re looking at the data. Intelligent means you’ve got to be intelligent about it because you got to have the analytics and be able to look at the patients, the population health empirically. We bring those three capabilities around those areas and it’s been taken very well in the marketplace. Read more: http://histalk2.com/2011/09/09/histalk-interviews-todd-cozzens-ceo-accountable-care-solutions-optum/
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