Almost half of hospital executives have no plans to implement an accountable care organization (ACO)-like model in the near future, according to a Purdue Healthcare Advisors survey.
Executives are also struggling to find solutions for lower reimbursements and increased costs, all while complying with the changes under the Affordable Care Act and maintaining quality care, states the survey, which polled more than 206 executives in October.
"This survey has identified a significant need for advocacy and education to support hospitals and help them survive the wave of changes brought on by the Affordable Care Act," Mary Anne Sloan, director of Purdue Healthcare Advisors, said in the survey. "Hospital executives are charged with enhancing patient care and managing margins with a shrinking workforce and diminishing patient volumes."
The survey found:
Hospital executives think ACOs are unstable and financially risky. Fifty-two percent said there were too many unknowns and want to see more consistency in successful models. Forty-nine percent thought their hospitals were too small for an ACO model, and 26 percent said the investment outweighed potential incentives or bonuses.
Financial concerns were prominent among hospital executives. Eighty-nine percent of executives are concerned with their hospitals' ability to address cost pressure. To combat those costs, more than half want to focus on reducing waste and inefficiencies, while almost 20 percent are considering salary and staff reductions, and 15 percent are working to improve quality of care to reduce costs.
Electronic Health Records (EHRs) drive a higher need for support. Executives are most concerned with the following EHR-related problems: interoperability with other providers, data retrieval and analytics, ongoing staff readiness and training, infrastructure and technology, patient engagement, security breaches, disaster recovery planning and long-term preservation of the records. They see physician adoption and usage, financial, employee training and readiness, technology, Meaningful Use qualification, vendor engagement and partnership, and patient engagement as the biggest challenges to implementing EHRs.
The success of ACOs has come into question in recent months. In July, the Centers for Medicare & Medicaid Services confirmed that nine will leave the experimental Pioneer ACO program, seven of which did not produce savings and intend to apply to the alternative ACO model, according to a previous FierceHealthcare report.
Securing financing, overcoming cultural resistance and complying with regulations are three of the biggest challenges to developing ACOs, FierceHealthcare previously reported.
To learn more:
- here's the survey announcement