[video] ACO Implementations, Improving Care Coordination and Outcomes for Populations

Date: 05.15.2013 | Zach Urbina">Zach Urbina

jennifer-jackman-270Monarch Healthcare is an independent physician’s practice association, one of the first to be recognized under the Pioneer ACO Program. Monarch’s Medicare Accountable Care Organization (ACO) provide healthcare to 17,000 Medicare beneficiaries at the time of this talk, in 2012 and with that number expected to grow to 23,000 by the end of 2013.

Jennifer Jackman, Monarch’s Sr. Vice President of Accountable Care, presented the experience that Monarch has gathered over the years, during her presentation at the Fall 2012 Accountable Care and Health IT Strategies Summit in Chicago.

Jackman opens by relating the frustration that some patients have toward the term ACO, which sounds to some like HMO (calling to mind the health maintenance organizations of the 1990s). She continues by giving a background on the CMS ACOs that run under the Medicare Shared Savings Program and how they differ from the Pioneer ACOs that are run by the Innovation Center, such as Monarch.  Both have similar goals in mind, transitioning from fee-for-service to fee-for-value.

Jackman continues to spell out the various financial elements behind Monarch, including the potential for upside and downside financial risk, based on performance, as evaluated by a number of agreed upon quality metrics. The primary aim and drivers are next examined.  The goal is to reach the triple aim of accountable care.

Monarch’s drivers include:

  • Advancing care coordination
  • Supporting patients
  • Achieving quality outcomes
  • Getting patient agreement and acceptance
  • Lowering per capita costs

The integrated care team that Monarch employs to achieve those goals seeks to “wrap care around the patient,” with nurse coordinators, care navigators, both in-patient and ambulatory, a high-risk touch team, pharmacists, and nurse practitioners. The goal remains to connect the patient with community resources and refer the patient as needed. [click to watch video - free registration required]

Bill Farry, the Chief Information Officer at Monarch continues with the second portion of the presentation by covering the technological elements of Monarch’s ACO.  In 18 years, Monarch built out a robust technology infrastructure which allowed them to hit the ground running with their ACO.

Practice Connect is a proprietary tool that allows the physicians in the Monarch network. The integrated platform that Monarch utilizes is intended to distribute data across their community, through a variety of settings, so that it can be leveraged as needed by physicians who may or may not be familiar with the patient they are providing care to.

To really keep them engaged and keep them at the table and owning the process, has been something that was a challenge. I can only encourage you to build those relationships with the providers. If you’re launching an ACO, you’ve got to keep that relationship there. Whenever you start rolling out the technology, they have to be at the table, they have to stay completely committed.

Farry continued by sharing some of the achievements that Monarch has secured with recent upgrades to their EHR. Challenges remain as each physician practice uses the same EHR, but those practices are not in touch with each other. Medical data is later shared with a health information exchange.  Monarch’s HIE exists essentially as a private information exchange, sharing health information strictly within its organization.

All this stuff is wonderful, but if you can’t insert it into the workflow of the physician, it’s not going to get used.

Leading Health Systems, Plans and ACOs will be traveling to San Francisco, September 10-12  for the 2013 Accountable Care and Health IT Strategies Summit. For inquiries regarding sponsorship please contact robw@healthcareitconnect.com and to submit a speaking proposal please contact victorias@healthcareitconnect.com

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