The success of accountable care models will hinge not only on the ability of all stakeholders to coordinate care across the continuum--from out-patient to inpatient, from rehab to preventive care--but also on the ability to engage patients in their "real" lives, such as the supermarket, the gym and the shopping mall, panelists agreed during a lively discussion at the Health IT Summit in San Francisco this week.
Critical to an ACO's financial success will be to identify patients who are at-risk for hospitalization, "and get to them early," noted Glenn Keet, president of Axolotl.
"It could save millions--if not billions of dollars," he said.
But among the many big unknowns--aside from ACO payment and structure, of course--are exactly who an ACO will be accountable for, noted family physician Katherine Schneider, VP of health engagement for Atlanticare.
"How do we engage patients and bring them into our system? How do we build ourselves as a brand to be accountable for their care" when many of an ACO's patients may be unknown, she asked.
Identifying and engaging these patients will require an aggressive communications strategy, and mind shift, by all ACO stakeholders, noted panelist Scott Young, senior medical director at Kaiser Permanente.
For example, instead of merely contacting patients for appointment reminders, primary care docs and specialists will also need to contact at-risk patients who don’t have appointments--but who require careful monitoring and engagement, he said.
Social media, email and even Twitter could become part of these outreach strategies, many of the panelists agreed.
"There's a whole generation of [young] patients coming up who will expect care to be provided differently," said Young, who heads up Kaiser's Care Management Institute.
To that end, providers will have to "do things you’re not necessarily going to be paid for," such as providing "desktop consultations" with patients via email or instant messaging to help keep patients on track, said David Nace, McKesson's VP and medical director.
"Accountable care is a team-based sport," he said.
About 125 providers, hospital leaders, health IT professionals and vendors attended the two-day meeting, hosted by the Institute for Health Technology Transformation.