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Hospital Impact has been ranked one of the top 50 healthcare blogs by Wikio.
Blogs we like:
In my last post on Hospital Impact, I discussed events that are taking place now to change the way care is delivered to U.S. citizens with pre-existing conditions and to retirees who are not yet eligible for Medicare. I would be remiss not to mention another development on the horizon that is affecting hospitals and physicians: Accountable Care Organizations (ACOs).
ACOs provide care for a defined patient population and are accountable for quality and cost associated with the care they provide. Because the providers assume varying degrees of financial risk, they can receive higher bonuses for achieving quality and spending goals.
The Patient Protection and Affordable Care Act Section 3022 requires the Secretary of Health and Human Services (HHS)--Kathleen Sebelius--to establish a Shared Savings Program by January 1, 2012, in which authorized providers contract with the Secretary to manage and coordinate care for Medicare beneficiaries for three years. Acceptable providers include group practices, networks of practices, hospital-physician partnerships and other groups that the Secretary deems appropriate.
ACOs must:
* care for at least 5,000 patients.
* have a sufficient number of primary care professionals.
* have defined processes to promote evidence-based medicine.
* coordinate care through telehealth, remote patient monitoring and other enabling technologies.
* meet patient-centered criteria established by the Secretary, such as the use of patient and caregiver assessments or the use of individualized care plans.
Keep in mind that 18 months is a short time to put together an ACO that meets the approval standards of HHS, as well as the standards of existing antitrust and anti-kickback regulations. As I mention in my ACHE seminar, the exact type of model is less important than the process by which a healthcare organization selects the model.
Successful processes are:
* Transparent: Conducted in an open manner without hidden agendas.
* Held in a spirit of inquiry rather than advocacy: Physicians want to feel invited for their unique perspectives rather than asked to rubber-stamp a previously made decision.
* Iterative: Recognizing that decisions made about models are the beginning of a journey rather than the end of the decision-making process.
In coming together, successful ACOs will need to reframe anger from disruptive global economic change into energy to transform into entities that cut costs and improve quality simultaneously. The old silos between clinical care and finance and operations are breaking down.
Do we live in interesting times, or what?
Ken is a practicing general surgeon/MBA and CEO of HealthcareCollaboration.com, who divides his time between providing general surgical coverage and speaking, writing, teaching, and consulting on physician-hospital relations. Please learn more about what he does by visiting http://healthcarecollaboration.com.
