Nontraditional care models gain traction

ACOs, PCMHs make headway in market
By Erin McCann
10:22 AM
Nontraditional care delivery models such as accountable care organizations and patient centered medical homes have been gaining traction in the healthcare arena, with more than half of physicians and other industry professionals now participating in these programs, according to new survey findings released Monday. 
The survey, conducted by health IT company eClinicalWorks, includes insight from more than 2,000 physicians and other healthcare professionals regarding their participation in and perception of various payment and care delivery models. 
Among the 47 percent who aren't yet participating in ACOs or PCMHs, approximately one-third anticipate their organization joining an ACO, PCMH or shared-savings plan in the next three years.
Healthcare professionals cited improving patient outcomes and better resource utilization as among the biggest motivations for participating in one of these models. 
When asked what features or capabilities of healthcare information technology systems might be valued by an ACO or PCMH, nearly all organizations with or considering an ACO or PCMH believe that EHR integration is important (95 percent) to create quality outcomes for patients. Survey findings also highlight additional features valued for creating quality outcomes include: 
  • Some 93 percent rate physician alerts for high-risk patients within the EHR as important; 
  • Some 93 percent rate care-planning and coordination tools as important; 
  • Approximately 89 percent rate risk-assessment tools/predictive analytics as important; and 
  • 86 percent rate patient engagement tools like online portals, smartphone applications, notifications to patients and patient satisfaction surveys as important. 
“It is obvious that the ACO and PCMH models are gaining traction,” said Girish Kumar Navani, CEO and co-founder of eClinicalWorks, in a press statement. “While there are some concerns, the majority of healthcare organizations either currently participates in or plans to become involved in these programs. They are also very clear on what tools will enhance their jobs. Our responsibility in this industry is to make sure these groups have the resources and technologies required to pursue better delivery of patient care.” 
In meeting the criteria of an ACO/PCMH, physicians and healthcare professionals indicated that a certain collection of tools are most valuable. The most significant features to survey participants include:
  • Standard reporting formats for quality measures that are designed for submittal as an ACO or PCMH (95 percent). 
  • Case management to coordinate care across multiple segments is equally important (94 percent). 
  • Ability to report on different quality measures for different payers (93 percent). 
  • Cost and utilization analytics (92 percent). 
Among the top challenges for these models survey participants cited include:
  • Surrounding compliance is effectively tracking and monitoring quality outcomes (76 percent). 
  • Second-ranked challenge is care coordination for patients across multiple points of care (72 percent). 
  • More than six in 10 current and prospective ACOs/PCMHs find the data extraction process for submitting required patient treatment and quality outcome data challenging. 
  • Nearly half (46 percent) of current and prospective ACOs/PCMHs extract data by manual chart audits (28 percent) or have not even been able to extract data (18 percent).