Operational problems identified by Medicare accountable care organizations (ACOs) after their first full year in existence overwhelmingly involved the use and dissemination of data, according to a newly published survey from the National Association of ACOs.
For the survey, NAACOS received responses from 35 ACOs started either in April or July of 2012. Forty percent of respondents said that the ability to access and process data from the Centers for Medicare & Medicaid Services was their biggest challenge in Year 1. Respondents said those issues stemmed from problems with:
- Suitable software
- Implementation schedules
- Claims data delays
- New skill sets to analyze data
- Slow stand-up of IT systems
- Data inconsistency from CMS
Eleven percent of the respondents identified IT operations alone as their biggest operational problem.
Additionally, ACOs were asked about IT systems used to process claims data--in particular, whether those systems were internal or external-- the cost of technology used and satisfaction with IT services. Fifty-two percent said that they used a combination of internal IT and outside vendors to get the job done; 24 percent said they used external vendors only, while an additional 24 percent said they used internal IT only.
The average total cost for technology use by the ACOs was $850,000. Satisfaction of IT services, on a 10-point scale, averaged a score of 6.4, with smaller ACOs less satisfied than larger ones.
Starting with the right kind of data is critical to the success of an ACO, Naveen Srabu, product management director for Liaison Healthcare Technologies, told an audience at the American Health Information Management Association Convention in Atlanta last fall. Srabu outlined three building blocks he said are necessary to develop the analytics component of an ACO from the ground up:
- Start with practice-level information, including standardized lab results and detailed patient information, if available.
- Develop a repository of "longitudinal" patient records including claims data, information from electronic health records and practice management systems, and data from related forms.
- Harmonize information that comes in from different practices, all of which have different interfaces, and determine what analytics you want to run to produce meaningful results.
Last spring, the Certification Commission for Health Information Technology published a 42-page IT framework to help organizations shifting into ACOs. Also last spring, the Institute of Health Technology Transformation published a report calling analytics the key to population health management and ACOs.
To learn more:
- read the NAACOS report (.pdf)