FH: What has the patient reaction been since the ACO launched?
GL: We were really pleased. For the 26,000-plus patients identified who were patients for us, we sent out letters to them. We already had a good relationship with them, and the letters had been crafted with CMMI to focus on the positive aspects of the program. We found that 98 percent of patients were interested in allowing us access to their data. There had been print media and broadcast media about mutual interest in ACOs. It wasn't a hard sell.
Had we been the only ones in the market doing it, it might have been a different experience.
FH: Partners HealthCare last month fielded some confusing calls from patients who didn't understand the changes to ACO. Hertiage California ACO also had some backlash when it sent out notification letters to patients. Were Atrius patients confused about the changes?
GL: We set up a telephone system so patients could call us. We actually created a much larger resource than we needed. We were very open in letting patients know that this is something we felt was beneficial for them.
Some of it is, quite frankly, the type of marketing. People clearly have the right to know what they're getting involved with and how their information will be used.
FH: What distinguishes Atrius Health in the ACO world?
GL: We are widely dispersed in all part of Eastern and Western Massachusetts. We have had a long history of putting together programs of care to fit in a global payment or capitated environment, and the way we practice is highly patient-centric. If you are going to be successful in an ACO, there needs to be a high level of collaboration between you and the patient.
The biggest difference between capitation and the Shared Savings ACO model is that patient. In a capitation contract, the patient can't leave you. But in an ACO model, you want to work so the patient doesn't want to leave you.
If we put out a program that's easier to access and focuses on the needs of families and the elderly--if we are prospectively looking at them and asking what problems might lie in the future and anticipating those problems with preventative activities, and making sure we use our resources to monitor the medications and make sure they're coming into see us in a timely, efficient fashion--then that's a service that most thoughtful people want to stay involved with. There's a win-win. If they stay healthier, they stay out of the hospital and have fewer needs for high-cost intervention--and we prospectively plan end-of-life support, if we are offering services to families dealing with complex problems of elders--then we believe that represents the sort of green pasture our patients wouldn't want to wander from.