Accountable Care Implementation Roundtables
Project Directors and leading HIT Strategists will lead roundtable discussions around specific technology and project initiatives that are at the leading edge of the Accountable Care and Health IT innovation and transformation process.
Danielle Sims, State Project Officer within the Office of Programs and Engagement, Office of the National Coordinator of Health IT, (ONC).
Regional Extension Centers: Trusted Advisors in the Field
Regional Extension Centers (RECs) have close working relationships with providers participating in ACOs, are aware of health IT challenges, and have structured service offerings around those challenges. As captured by ONC’s FACA ACO workgroup, major challenges ACOs face includes: patient engagement, quality measure abstraction, aggregation, and reporting, vendor/EHR product, data exchange among providers, IT strategy, scaling notification services, and population health management. Health IT plays a significant role in overcoming these challenges; RECs have been providing health IT and practice transformation services to support providers who face these barriers.
David Overton, Executive Director of Clinical Integration, St. Joseph’s Regional Health Center
St Joseph Health Partners: Surviving and Thriving in Payment Reform
St Joseph Health Partners (SJHP) is a Clinically Integrated Network formed under FTC guidance to lead the St Joseph Health System into the future of pay for performance and value based purchasing. SJHP is focused on 4 key strategic imperatives as it relates to payment reform; Medicare ACO, Commercial payer partnerships, Patient Centered Medical Home, and Care Coordination. SJHP is in year 1 of the 3 year Medicare Shared Savings Program and is focusing on reducing readmissions and inappropriate utilization of healthcare services through care coordination. SJHP has partnered with a national commercial payer to manage the health of the St Joseph Employee Health Plan but also to co-brand a health insurance product that drives steerage to the health system and creates incentives to steer patients to the lowest cost and appropriate healthcare services through the medical home.
Sandy L. Chung, MD, CMIO, Health Connect ACO
Advancing Consumer Engagement in a Physician Lead ACO
John Clark, MD, JD, CMO, IU Health ACO
Transition from Fee-for-Service to Value-Based Payments
Medical groups entering the world of Population Health Management face several challenges negotiating the transition from Fee for Service to Value-Based payments with their physicians. Indiana University Health Physicians (IUHP) has been putting a significant portion of its primary care physicians’ salaries at risk for quality, patient satisfaction, and access to care for more than 15 years. Over the last three years the advent of Accountable Care / Shared Savings and full-risk contracting has challenged the group to provide incentives for its physicians aligned with quality of care and service to the whole population of patients it serves while simultaneously encouraging the transformation of office-based work flow to effectively manage value-based contracts. IUHP has met these challenges with both contractual incentive programs focused on technical quality of care, patient satisfaction, and patient access to care for which the physicians feel a reasonable degree of control as well as team and region-based shared savings incentives tied directly to overall cost of care for risk populations. Importantly, IUHP has negotiated for fixed up front “transactional” payments for physicians participating in processes designed to maintain quality of care while improving care coordination for the sickest of patients. Using these dual mechanisms IUHP ensures that quality of care and patient satisfaction stay at the forefront of care delivery processes while allowing those processes to evolve to meet the needs of population health management.
Linda Oliver, Director of ACO Implementation, Atrius Health
Identifying At Risk Populations and Operationalizing Data for Care Interventions
Craig Behm, Executive Director, MedChi Network Services
Exploring the Network Services Model for Primary Care Transformation in Maryland
MedChi Network Services (MNS) is a management services organization founded by MedChi, the Maryland State Medical Society. The mission to support the private practice of medicine was originally carried out through practice support such as revenue cycle management, coding reviews, EHR optimization, and other related services. When medical society leadership reviewed the final ACO regulations – including physician-leadership, no downside risk, and an advance payment program – they encouraged MNS to expand their service offerings and organize physician groups. Working in the rural parts of the state, MNS was able to form 3 MSSP ACOs consisting entirely of independent, primary care physicians. The challenges faced during the last two years of integrating over 30 different practices with a dozen EHR systems have been significant, but they also offered numerous opportunities to add value at the point of care. MNS is transforming primary care physicians into population health managers.