ACOs need 'more' than an EMR

There's no way around it: Accountable Care Organizations, or ACOs, are the future of healthcare in the United States, and providers had better get on the bus sooner rather than later.

Attendees at the ACO Symposium at HIMSS12 appeared to recognize this, as Monday's pre-conference event was standing room only.

Antonio Linares, MD, medical director at Wellpoint, reassured the audience that "unlike most things you encounter in Las Vegas, there is a win-win relationship for all those involved with ACOs."

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ACOs, as defined in Section 3022 of the Patient Protection and Affordable Care Act, bring together primary care providers, specialists and other providers to manage the full continuum of patient care and assume accountability for the total costs and quality of care for a defined population.

Healthcare information technology is the essential backbone for ACOs, said Joe Damore of Premier, Inc. Damore told attendees that the comprehensive IT needs of ACOs extend beyond an electronic medical record system that links a hospital and physician practice. He said ACOs need an HIE, a population health data management system, a robust business intelligence and predictive analytics platform, and ultimately a consumer health platform or portal.

Linares emphasized the data exchange and reporting function of ACOs. He said IT executives would be asked to focus intently on reporting analytics as ACOs take hold.

"We need to develop real-time information exchange for disease management. ACOs will ultimately require us to transfer data bi-directionally in real-time from provider to health plan."

While the future may be boundless for ACOs, Linares said the current menu of ACO options for providers include the Medicare Shared Savings Program, the Advance Payment ACO Model; and the HHS Pioneer ACO program.

"There's a real opportunity for greater gain sharing in the Pioneer program," Linares said.

Most of the Symposium speakers praised the final ACO rules released late last year by the Department of Health and Human Services. Linares said HHS "really listened to constructive comments from stakeholders" and made positive changes to the proposed rules.

A redesigned healthcare delivery system, of which ACOs are a critical component, will ideally lead to improved population health and better cost control, but should also improve the care experience for patients, Damore said. The process builds directly on the "Triple Aim" designed by former CMS administrator Don Berwick, MD, while he led the Institute for Healthcare Improvement.