Patient-centeredness required in the ACO boardroom

"Genuine patient-centeredness is more than mints-on-the-pillow at the hospital, a hearty handshake from the doctor and a couple of reminder emails to take your medications after you get home," according to Michael L. Millenson, president of Highland Park, Ill.-based Health Quality Advisors and the author of a white paper on building accountable care organizations with the patient at heart. "It's important for policymakers and providers alike to recognize that deeply engaging patients in multiple ways is critical to ACO success," Millenson said in a statement yesterday.  

The white paper is by consulting firm Health Quality Advisors and the nonprofit National Partnership for Women & Families and funded by Aetna, the insurer who recently announced its ACO partnership with Phoenix-based hospital network Banner Health. It points out that governance-level requirements must focus on patient-centeredness.

Millenson described the patient's traditional role in his or her own care like a car door that simply gets fixed up on the auto assembly line. However, today, the patient's role is changing under the Patient Protection and Affordable Care Act. The patient is now in the driver's seat, with the Centers for Medicare & Medicaid Services emphasizing that the patient have a seat on the board in how care is delivered; ACOs under the Medicare Shared Savings Program must have one beneficiary and Pioneer ACOs must have a consumer advocate, although the beneficiary and advocate can be the same person, according the white paper.

"Consumer engagement, whether in the exam room or in a healthcare organization's boardroom, is a central element," Millenson wrote.

Even though patient-centeredness could improve care and costs, clinicians still are reluctant to involve patients in decisions, particularly with the federal ACO programs.

"It has taken a full century for the patient's perspective to go from being routinely ignored to being hailed as a pillar of an ideal healthcare system," Millenson said. However, he noted that health institutions will eventually get on the bandwagon to stay competitive. "The organizations that embrace it may be ahead of the pack, but there is no doubt that others will soon follow after."

To learn more:
- read the statement
- check out the white paper (.pdf)

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