Implementing an accountable care organization is nearly impossible without high-quality clinical engagement, according to a panel of healthcare leaders at Friday's sixth annual National ACO Summit in the District of Columbia.
And that engagement requires clinical leadership among the workers who are directly involved in care delivery, including physicians, non-physician providers, clinical staff and clerical employees, said Terry McGeeney, M.D., president of Care Accountability, Inc., and a visiting scholar at the Brookings Institution, who served as the moderator of the panel.
"The [leadership] question I think we need to ask today is, where is the 'there' that we're trying to get to?...We need leaders who understand that the 'there' of today is probably not the 'there' of tomorrow," he said, noting that this can be a problem with physician leaders, who tend to be more change-averse.
The Pioneer ACO at Steward Health Care in Massachusetts--one of the top performers in the program its first year--fosters clinical engagement by aligning incentives and goals throughout the staff, rather than just among physicians. David Morales, executive vice president and chief strategy officer, said the organization tries "very aggressively" to meet with doctors and non-physician providers each month to show them how they perform on key metrics.
Boston's Beth Israel Deaconess Care Organization President and CEO Christina Severin. suggested that ACOs take a hard look as to whether physician leaders would better lead the organization or whether health coach or care navigator leaders may be more appropriate. She believes an approach that "de-medicalizes" issues, can help engage clnicians as well as patients.
Patient engagement is also a critical component to an ACO's success because it can lead to improved, care quality and compliance, and will also strengthen retention and loyalty for patients and employees alike, panelists said.
Steward has made great strides in both patient retention and engagement of the racially diverse, multilingual patient population of Eastern Massachusetts. Since joining Medicare's Pioneer program, Morales said, the agency has helped the organization develop an "operational chassis"--an infrastructure through which the system coordinates care for Medicare, commercial and Medicaid patients. This is vital to Steward's goal of being a "payer-agnostic" provider, he said.