A recent HealthAffairs articleoutlines the results of a study of Large Multispecialty groups and their readiness for new payment reform. As provider groups prepare themselves to take on new risk models, the success factors for building successful models of accountable care are clear: results-based payment models for physicians, strategic goal setting and effective management (e.g. targeting ED high flyers or reducing readmissions) and of course, effective information management systems.
Look Ma, I’m building an ACO
What was interesting is that even among the ‘advanced groups’ in the study – meaning those who operated on a majority of risk-based contracts (71 percent on average), these success factors are hardly fully implemented. For example, the risk-based groups still doled out about half of their compensation (to both PCP’s and specialists) in volume-based contracts (compared to 85 percent of the FFS group). The management strategy was a little bit better, with 82 percent of those practices having implemented some kind of targeted policies or programs for readmission, compared to 70 percent of the FFS group.
Where did the Risk-based advanced group really blow their FFS counterparts out of the water? Data Management. While both groups fared well in having a shared EMR or a results management system (radiology/lab tests integration), 100 percent of the risk-based groups had a data warehouse and analytic software, 60 percent had disease registry systems, and 70 percent had practice variation analysis software. Only 10, 20, and 10 percent of the FFS practices, respectively, had implemented those systems.
So what does this mean?
Quite simply, advanced data management capabilities are at the heart of an effective accountable care model. Nothing we didn’t know before – but still a green light for the analytics industry and vendors who prove themselves in the space in the coming months.
EDIT – This article just came out. ACO’s are expected to spend $1-4 million depending on their size.