With the advent of new payment models in the healthcare industry and the subsequent growth of accountable care organizations, the Workgroup for Electronic Data Interchange (WEDI) formed a workgroup--the Payment Models Workgroup--to create a framework surrounding ACOs.
The workgroup this week has released a paper on barriers and best practices of ACOs, as well as questions for future consideration as it provides guidance on the new payment models.
Three topics the paper addresses include:
- Population health management: Taking the care of a whole population into consideration, instead of just the individual, is something ACOs require. To monitor outcomes and collect data for one person and a whole community, organizations need "a core health IT infrastructure and analytic solution(s)," the paper's authors write. Data will be key both at the patient level and a population level, and because of this, they say, it will be important to consider what data and tech is needed for PHM.
- Health IT infrastructure: For an ACO to be successful, it must have a defined and strong IT infrastructure. As ACOs mature, more technologies will be added to that infrastructure, and with that will come a stronger need for interoperability of data, the paper says. This is something ACOs currently lack; they are not "able to seamlessly push or pull complete patient health data in an accessible and timely manner." WEDI CEO Devin Jopp noted the importance of interoperability for new payment models in a recent interview, saying: "Payment models are demanding quality data to move faster. We need the information to be able to flow more easily so we can make important decisions on these in the new payment model[s]."
- Data and analytics: New technologies will be needed by ACOs to analyze the myriad health data flowing in from patients and populations. The authors say they will need to look at the "pain points" for collection, measurement and exchange of such information. In addition, it will need to be addressed whether there are business cases for predictive and prescriptive analytics, they add. Making data precise and useful is one of the biggest challenges ACOs currently face, Joel Vengco, vice president and chief information officer of Springfield, Massachusetts-based Baystate Health, said in a recent interview.
ACOs also are being required by the Centers for Medicare & Medicaid Services to describe how they will promote the use of health IT to boost care coordination when applying for he Medicare Shared Savings Program.
To learn more:
- read the paper (.pdf)