Can ACOs and Meaningful Use goals peacefully coexist?


Will the goals of accountable care organizations (ACOs) and Meaningful Use initiatives complement each other--or counteract each other like oil and water when it comes to delivering quality, efficient care?

The question has been around for a while, but garnered some attention this week. On Tuesday, the College of Healthcare Information Management Executives (CHIME)--a group of 1,400 chief information officers and other executives from hospitals across the country--sent a letter to the Centers for Medicare and Medicaid Services (CMS) responding to a notice of proposed rulemaking on ACOs.

Among the issues raised by CHIME was a provision that would let Medicare beneficiaries who see a primary-care physicians in an ACO bar the organization from using their claims data to improve performance. While this opt-out provision on data sharing would be easier to administer than an opt-in provision, CHIME said, "it contraindicates efforts to provide accountable care."

CHIME, in its letter, also said ACOs should be allowed to make decisions based on business requirements to achieve care coordination/information system domain requirements--rather than "prescribing Meaningful Use objectives as necessary" to be a participant in an ACO.

On Wednesday, though, Farzad Mostashari, MD, the newly named national coordinator for health IT, said at the beginning of the Health IT Policy Committee hearing in Washington that no hospital CIO should feel that he or she has to make a choice between "do I prepare for accountable care or do I go for Meaningful Use?"

"That should be a false choice," he continued. Health IT and its related incentive programs linked to electronic health records (EHRs) "do not live within a vacuum...they are part of a larger system of health transformation that we can benefit from," he said.

In upcoming months, CMS will be responsible for laying out new rules related to both ACOs and the new Stage 2 of Meaningful Use. Rather than emphasize the contradictions, Mostashari suggested that now is the time to look at Meaningful Use "as a roadmap of what we need to do to succeed as a country and as individual healthcare providers."

I agree. After all, the goal should be finding ways to promote quality, value, and efficiency--which we should be looking for through Meaningful Use of EHRs and ACOs together. - Janice

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