HANYS Co-Hosts Program on Strategies for Successful Hospital-Physician Alignment

HANYS will co-host a program exploring ways physicians and hospitals in New York can form practice entities that benefit physicians, hospitals, and patients. The program, co-hosted by the New York Society for Health Planning and Academy of Medicine of Queens County, will review the financial, organizational, legal, and accounting issues critical to successful alignment.

http://www.hanys.org/news/index.cfm?storyid=1687

Experts Believe Lack Of Incentives And Financial Interests Are Barriers To Integrated And Accountable Care

Nearly nine of 10 leaders in health care and health care policy think that the lack of incentives and current financial interests of providers and other stakeholders are barriers to moving health care toward more integrated and accountable delivery models. The latest Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey, published yesterday, asked leaders their views on barriers to delivery system innovation and strategies for fostering more accountability and coordination among health care providers.

http://www.medicalnewstoday.com/articles/195949.php

Primary care vital for patients

Now that the Patient Protection and Affordable Care Act is law, federal agencies are developing the policies, regulations and funding that will implement many of its provisions.
It is estimated that 32 million additional Americans will become insured when the law's mandated insurance provision, along with federal subsidies for low-income individuals, take effect in 2014. This influx of newly-insured individuals is expected to substantially increase demand for health care, especially primary care.
Effective primary care improves health and helps to control care costs. Primary care is the ideal entry point into the health care system, rather than costly hospital emergency departments. Primary care encompasses disease screening, diagnosis and treatment of many medical conditions, education of patients, and management of some chronic illnesses as well as when to refer a patient to a specialist. From The Detroit News: http://www.detnews.com/article/20100727/OPINION01/7270315/1008/opinion01/Primary-care-vital-for-patients#ixzz0uudrRsMM

The Hospital, Your Care Coordinator

Hospitals aren't known for making house calls. Once patients get their discharge papers, they take their chances with a family doctor or staffers at a clinic who may or may not know what happened inside the hospital's walls. So Margaret Bennett's experience is pretty rare. Bennett, 84, who had a stroke 11 years ago and colon cancer in 2007, recently spent two weeks at Montefiore Medical Center in the Bronx because of a blood clot in her leg. In many places, such a frail and elderly patient might be hospitalized for weeks or even months, but Bennett's doctor now comes to her.

http://health.usnews.com/health-news/best-hospitals/articles/2010/07/26/the-hospital-your-care-coordinator.html

SCCIPA Expands Use of the Health Access Solutions Multidisciplinary Care Coordination Platform

Integrated Solution to Accelerate Progress towards the Patient-Centered Medical Home and Support the Individual Practice Association’s Goal of Becoming a Tier 3 Accountable Care Organization

FOSTER CITY, Calif.--(BUSINESS WIRE)--Health Access Solutions, offering a multidisciplinary care coordination platform, today announced that the Individual Practice Association Medical Group of Santa Clara County, Inc. (SCCIPA) will significantly expand its use of Health Access Solutions applications. The extended solution enables emerging patient-centric models such as medical homes and accountable care initiatives.

http://www.businesswire.com/portal/site/home/permalink/?ndmViewId=news_view&newsId=20100722006590&newsLang=en

Accountable Care Organizations Can Increase Profitable Patient Volume

There is still much we do not know about the effect of health reform, but one thing that seems certain is that some form of accountable care is coming.
What is an Accountable Care Organization?
Here is the shortest version:

Payers, employers, the government will assign patients to health care organizations and make them accountable for the health and wellness of that population.
So right now we get paid by episodes of care. We drive high-contribution services and DRG’s into the hospital.

http://www.turnupyourvolume.com/2010/07/13/accountable-care-organizations-can-create-profitable-patient-volume/

Carilion closing in on new health care approach

Carilion Clinic's efforts to systematically change the way it provides health care are coming into sharper focus.

The region's largest health care provider is pulling data and inking plans to help patients establish stronger relationships with their primary care doctors in an effort to keep patients out of the hospital and away from the emergency room. At the same time, Carilion's executives say they are closer to signing a deal with private insurance companies to establish a new payment system that rewards keeping patients healthy.

http://www.roanoke.com/news/roanoke/wb/254765

Five Reasons Why Group Practices, Not Hospitals, Will Run ACOs

The American Medical Group Association, representing large group practices, played a central role in shaping accountable care organizations and sees group practices, and not hospitals, as the mainstay of ACOs, according to Chet Speed, vice president of public policy for AMGA. In ACOs' evolution, "we were there at the beginning," he says. CMS' five-year-long Physician Group Practice Demonstration, which sought to improve efficiency at group practices by coordinating care, was winding down when the healthcare reform bill was being drafted. AMGA, which claimed nine of the project's 10 participating group practices as members, proposed a new program based on the demonstration to Senate staffers.

http://www.beckershospitalreview.com/hospital-physician-relationships/five-reasons-why-group-practices-not-hospitals-will-run-acos.html

A five-year project aimed at keeping New Hampshire patients healthier

Five groups of hospitals and other health care facilities, including Exeter Health Resources, will become “accountable care organizations” in a project that attempts to tackle what many consider to be a big problem in the current system: having accountability spread across hospitals, doctors' offices, insurance carriers and employers with no one group responsible for the overall management of care.

http://www.fosters.com/apps/pbcs.dll/article?AID=/20100722/GJOPINION_01/707229872

Investors expect healthcare M&A uptick through 2Q 2011 because of ACO formation

Merger-and-acquisition (M&A) activity across the entire healthcare industry is likely to become even more frenzied--or at least sustain its current increased pace--over the next year, according to the "Life Sciences & Healthcare Sector Forecast" from the M&A intelligence service mergermarket, the law firm Epstein Becker & Green, P.C., and the investment bank Rodman & Renshaw. The forecast is based on second-quarter 2010 interviews with more than 75 U.S.-based healthcare investors.



http://www.fiercehealthfinance.com/story/investors-expect-healthcare-m-uptick-through-2q-2011/2010-07-21

Medicare driving health care hookups-ACOs

The scramble by local hospitals to form their physicians and facilities into “clinically integrated” networks that can do business with employers and health insurers has another huge motivating factor: Beginning January 2012, they can also do business with Medicare, the massive federal program for seniors.

http://www.ibj.com/new-medicare-contracts-drive-health-care-hookups/PARAMS/article/21197

MedAssets Addresses Payment Reform with Bundled Reimbursement Solution

MedAssets, Inc. /quotes/comstock/15*!mdas/quotes/nls/mdas (MDAS 23.45, +0.30, +1.30%) announced today that it has launched a bundled reimbursement solution to help healthcare providers and payors transform their delivery models in order to succeed in a reformed healthcare environment where development of Accountable Care Organizations (ACOs) and bundled payment strategies is a necessity.

http://www.marketwatch.com/story/medassets-addresses-payment-reform-with-bundled-reimbursement-solution-2010-07-21?reflink=MW_news_stmp

Building an Accountable Care Organization

A glance at the headlines shows how badly healthcare needs to become more efficient. Healthcare spending in the United States rose 5.7 percent in 2009, to $2.5 trillion. It now commands 17.3 percent of the gross domestic product, up from 16.2 percent in 2008. That's the fastest one-year increase since 1960.

Our healthcare system is galloping away from us. We spend more than $7,000 per person on medical care, much more than any other country we compete with in the global market. China, for example, spends $600 a year. How can we as a nation keep this up? The economic burden of our healthcare system is simply unsustainable.

Enter the Accountable Care Organization
Hospitals need to become more efficient and control costs. I believe this can be done through accountable care organizations. ACOs will coordinate all the care a patient receives, both inside and outside the hospital, in a certain region. For example, an ACO in my part of Wisconsin might serve 800,000 to 1 million people. The ACO would bring together hospitals, physicians and other providers into coordinated systems that can be more efficient and safer, too.

http://www.beckershospitalreview.com/hospital-physician-relationships/building-an-accountable-care-organization.html

What ACOs Mean for Hospitals: Q&A with Dr. Marc Bard of Navigant Consulting

Q: What role do accountable care organizations play in healthcare reform?

Dr. Marc Bard: ACOs make up only a small portion of the reform law, way out of proportion to the interest and enthusiasm they have garnered from healthcare leaders. The law makes just 14 stipulations about ACOs. They have to bring together "groups of providers of services and suppliers meeting criteria specified by the [HHS] Secretary"; they have to be "willing to become accountable for the quality, cost and overall care of the Medicare fee-for-service beneficiaries assigned to it"; and they have to enter into a three-year agreement at minimum.

http://www.beckershospitalreview.com/hospital-physician-relationships/what-acos-mean-for-hospitals-qaa-with-dr-marc-bard-of-navigant-consulting.html

Craig N. Melin is president and chief executive officer of Cooley Dickinson Hospital, Northampton, Mass. weighs in on ACOs

There are four critical components to this future: quality, safety, health focus, and value. Some of the critical components are tougher to achieve in the current fee-for-service environment, but we at Cooley Dickinson are focused on them nonetheless.

http://www.masslive.com/opinion/index.ssf/2010/07/viewpoint_cooley-dickinson_hos.html

What reform means to an Indiana town and ACOs will contribute

Q: What other problems do you think the new law will potentially solve?

White: If we think about it long and hard, we probably could see some advantages in increasing quality, having more providers working together for the good of patient care. There is a model out there called an Accountable Care Organization that has the potential of rewarding (health care) providers for delivering very, very good care in the most efficient way. That doesn't mean cheap — it means efficiency. Now, the Department of Justice and everybody else has to weigh in on this, but you will hear more about an Accountable Care Organization, an ACO. ... So if we can align the quality incentives and the financial incentives, I see some opportunities. It's going to be a lot of work.

http://www.courierpress.com/news/2010/jul/17/health-systems-eyeing-incoming-reforms/

Robert J. Samuelson writes of Newsweek weighs in on what to expect from ACOs

If you want a preview of President Barack Obama’s health-care “reform,” take a look at Massachusetts. In 2006, it enacted a “reform” that became a model for Obama. The state did the easy part: expanding state-subsidized insurance coverage. It evaded the hard part: controlling costs and ensuring that spending improves people’s health. Unfortunately, Obama has done the same.

http://www.dispatch.com/live/content/editorials/stories/2010/07/18/massachusetts-acts-as-health-care-crystal-ball.html?sid=101

Clayton Christensen weighs in on Reform and ACOs possible contribution

Clayton M. Christensen: Health Insurance Rate Wars – Are We Focused on the Right Fight?

http://www.investingcontrarian.com/financial-news-network/clayton-m-christensen-health-insurance-rate-wars-are-we-focused-on-the-right-fight/

New Hampshire facilities forming an ACO

The five sites will become "accountable care organizations" in a project that attempts to tackle what many consider to be a big problem in the current system: having accountability spread across hospitals, doctors' offices, insurance carriers and employers with no one group responsible for the overall management of care.

http://www.businessweek.com/ap/financialnews/D9GVLM8O1.htm

Michigan hospitals move towards an ACO

Superior Health Partners trustees have finalized the formal affiliation agreement that went into effect on July 1 between Marquette General Hospital and Bell Hospital in Michigan's Upper Peninsula. Elected board officers are outlining initial priorities for the accountable care organization, the health system announced today.

http://www.healthleadersmedia.com/content/FIN-253833/Marquette-General-Health-Bell-Hospital-Affiliation-Now-Official

Maine's mental health caregives moving into an ACO

As the law presently reads, health care in Maine -- and the nation -- will need to be accessible to more and delivered less expensively, yet more effectively, than it is today.

One of the key assumptions of health care reform is that the creation of Accountable Care Organizations will improve the health care system.

http://www.pressherald.com/opinion/local-caregivers-ready-for-reform-of-the-mental-health-care-system_2010-07-15.html

From Siloed Care to Systems-Based Accountable Care Networks: Hope For The Safety Net?

A recent independent assessment and analysis of the Los Angeles County Department of Health Services Office of Managed Care by Health Management Associates (HMA) provides a clear blueprint for the successful transformation of an uncoordinated safety net to an integrated and coherent health care delivery system. I am convinced that the challenge of retaining current Medi-Cal patients, recruiting new patients, and providing cost effective services to the remaining indigent population in Los Angeles County (as mandated by California Law) can be achieved over the next 5 years.

http://www.huffingtonpost.com/brian-prestwich/from-siloed-care-to-syste_b_646599.html

Palmetto Health Forms Accountable Care Organization Called Palmetto Health Quality Collaborative

COLUMBIA, S.C., July 13 /PRNewswire-USNewswire/ -- The Palmetto Health Board of Directors has unanimously approved the establishment of Palmetto Health Quality Collaborative, LLC, often referred to as an accountable care organization (ACO). The Quality Collaborative will be a physician-led, patient-centered, interdependent medical entity that focuses on best practices in clinical outcomes and evidence-based care. Palmetto Health will soon begin offering the more than 1,000 physicians on its medical staff an opportunity to join.

http://www.prnewswire.com/news-releases/palmetto-health-forms-accountable-care-organization-called-palmetto-health-quality-collaborative-98359734.html

How can hospitals prepare for ACOs

How Hospitals Can Prepare for Accountable Care Organizations: Q&A With Robert Baudino of Baudino Law Group

http://www.beckershospitalreview.com/hospital-physician-relationships/how-hospitals-can-prepare-for-accountable-care-organizations-qaa-with-robert-baudino-of-baudino-law-group.html?sms_ss=twitter

Very Interesting Take on ACOs

This video, by healthcare consultant Anthony Cirillo, offers a neat suggestion — why not sic Steve Jobs on the accountable care organization model? As Cirillo sees it, Jobs is one of few execs out there who really understands how to build complex things in a lean, functional way.

http://coolweather.dreamhosters.com/general/video-accountable-care-organizations-the-steve-jobs-way.html?utm_source=twitterfeed&utm_medium=twitter

CEO of Billings Clinic on YouTube about ACOs

http://www.youtube.com/watch?v=pw9w7l7j780

Will ACOs Deliver?

http://www.mathematica-mpr.com/publications/pdfs/health/account_care_orgs_brief.pdf

More on the accountable care front

Atlantic Information Services’ Health Business Daily reported that at the Accountable Care Organization (ACO) Summit in Washington, D.C. on June 8, attorney Noah Rosenberg commented, “Everyone wants to form one, and they don’t know what it is, and neither do I.” Rosenberg is a former Health and Human Services general counsel.

http://blogs.hcpro.com/mdscentral/2010/07/more-on-the-accountable-care-front/

What to do with the hospital D.C. now owns? Creat an ACO?

The District could create accountable-care organizations consisting of primary-care physicians, specialists and at least one hospital. In such an ACO, providers would be responsible for achieving high-quality care based on improvements that can be measured, leading to reduced spending growth.

http://www.washingtonpost.com/wp-dyn/content/article/2010/07/10/AR2010071002539.html

Will insurers control healthcare costs better?

Growing supply-side concentration. Over the past decade, the supply side of the health care sector in many localities has become ever more concentrated, as hospitals formed systems and physicians joined together in larger groups. The current nouvelle vague – so-called Accountable Care Organizations (ACOs) – will only further encourage that concentration. I find it hard to believe that, in the face of this trend, fragmenting the buy side of health care even more would serve the goal of cost containment.

http://healthaffairs.org/blog/2010/07/09/will-more-insurers-control-health-care-costs-better/

Pharmacists should get in on ground floor of ACOs

ACOs need flexible models, payment approaches, and a learning system, Health Affairs paper recommends.

Under the Affordable Care Act, accountable care organizations (ACOs) will be tested starting in January, and now is the time for pharmacists to be figuring out how they will be involved at the local level, a former CMS official said. "Pharmacists can and should be a part of this," S. Lawrence Kocot, MPA, JD, LLM, Deputy Director of the Engelberg Center for Health Care Reform at the Brookings Institution in Washington, DC, and Senior Counsel at Sonnenschein, Nath and Rosenthal, said when he addressed APhA’s Academy Leadership Meeting in April.

http://www.pharmpro.com/News/Feeds/2010/07/agencies-and-organizations-american-pharmacists-association-pharmacists-should-get-in-on-ground-floor-of-acos/

Ensuring Your Hospital Thrives as an Accountable Care Organization

ACOs are the future of health care. A five-step plan will prepare your organization for upcoming changes.

http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/07JUL2010/071210HHN_Weekly_Silverstein&domain=HHNMAG

Come 2012, Clinical Pathology Laboratories Will Need to Support Accountable Care Organizations

Pathologists and clinical laboratories are positioned to benefit from the provision in the Affordable Care Act of 2010 that is intended to reduce the cost of healthcare. It is the provision which authorizes the use of “accountable care organizations” (ACOs) and will be triggered in 2012.

http://www.darkdaily.com/come-2012-clinical-pathology-laboratories-will-neet-to-support-accountable-care-organizations-071210

Marquette General Hospital and Bell Hospital formalize affiliation as they move towards ACO model.

“With the legal documents signed, our new board officers in place and our strategic plan outlined, we can move forward with plans to create an Accountable Care Organization, which relies on close hospital partnerships, collaborative alignment with physicians, robust information technology infrastructure and operational expense management,” said Larson, who also serves as Marquette General Health System Board chairman.


http://www.uppermichiganssource.com/news/story.aspx?list=~%5Chome%5Clists%5Csearch&id=477921

American Medical Group Association ACO Readiness Assesment

The Readiness Assessment Tool is provided by AMGA to assist healthcare
organizations in evaluating their readiness to succeed as an Accountable Care
Organization (ACO). In order to produce successful clinical and financial
outcomes, the elements of organizational structure, governance, and care
coordination all must be robust and systematically working together to
manage patient care from a population perspective.

http://www.amga.org/Research/Research/ACO/assessTool.pdf

ACO Conundrum: Everybody Wants in the Game, but Nobody Knows the Rules

Preparations among would-be participants in Medicare Accountable Care Organizations (ACOs) under the health reform law now are at a critical but semi-impossible stage, based on comments at a major conference June 7-9.

http://www.aishealth.com/Bnow/hbd070110.html