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Summit: ACO success tied to EHR, HIE capabilities

October 06, 2010 | Patty Enrado, Special Projects Editor

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SAN FRANCISCO – Mature electronic health record systems and health information exchange capabilities contributed to the success of five of the 10 accountable care organization (ACO) demonstration sites funded by the Centers for Medicare & Medicaid Services, according to a CMS official.

The findings are preliminary, and the project data is under review, said Anthony Rodgers, deputy administrator for CMS’s Center for Strategic Planning, on Tuesday during the National Regional Extension & Health Information Exchange Summit West in San Francisco.

Still, the common denominator of advanced health IT for the five ACOs represents validation for the technology's ROI. The five sites got the “lion’s share” of the $36 million that was the reward for meeting CMS’ goals of better care, reduced per capita costs and improved population health.

“If that’s not a business case, I don’t know what is,” Rodgers said.

CMS envisions three evolutions of the medical home, he added. Medical Home 1.0 encompasses EHRs, e-prescribing, coordination of care and patient care management, but no ROI. Medical Home 2.0 adds advanced clinical decision support and the broader application for chronic care management.

Medical Home 3.0, however, combines managing cost and population health with a fully connected office, community health strategy and new relationships and business partners, Rodgers said.

The industry, with CMS as part of the vanguard, is moving away from fee-for-service, episodic and non-integrated care to ACOs with EHRs and finally to patient-centered, integrated healthcare that aligns incentives with the three goals.

The model is organically aligned to achieve CMS’s goals, while also changing the financial incentives to global rates, shared savings and capitation, which will motivate groups to better manage their patients, Rodgers said.

Rodgers said he didn’t know when the peer review would be completed, but once the findings were complete the results would be posted on CMS’s website.

Related Topics:
  • Anthony Rodgers
  • CMS
  • Medicare
  • San Francisco
  • Electronic Health Records
  • Health Information Exchange (HIE)

Reader Comments (3)Login to Post a Comment

lkwd_read says: ACO
October 16, 2010 | 12:40PM GMT

Initial attempts at ACO should focus on incenting providers to share data and clinical care teams amongst their own organizations. Many "integrated" health networks are anything but. With the introduction of these demonstration projects, having all clinical data shared amongst one IDN would be real progress.

anonMD says: Glaring Discrepancy
October 07, 2010 | 2:00AM GMT

The Medical Home concept is more likely destined to the fate of the HMO than to a major role in American medicine; the economics, despite the government's praise (they aren't biased, are they?) simply don't hold up. EMRs offer advances in care coordination, but they're buried under the advances in insurer coordination to the extent that they will be irrelevant to the attitudes of the patients. Primary care MDs are returning to truly private practice - i.e. no insurance accepted - in rapidly increasing numbers, and the nurses who are replacing them will simply cause CMS to drop payments even further, thus accelerating the trend. Corporations will lose interest in the medical home concept as the downward payment spiral continues, just as they did with HMOs, and the public won't tolerate the DMV conditions that will inevitably ensue if the government takes over the clinics after corporate medicine bails out.

Alan Gilbe says: ACO success tied to EHR, HIE capabilities
October 06, 2010 | 12:45PM GMT

In addition to strong EHR and HIE capabilities, in order to have a strong ACO or Medical Home Technology platform, you need a colloborative and coordinated care platform that includes strong chronic disease management and strong multi-disciplinary team management in order to manage diverse care teams focused around a primary care provider.

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