ACO Deadline Draws Near: What this Means for Providers

By Eric Zerneke

Since the entire healthcare industry is at HIMSS12 next week, this is a good opportunity to discuss an important deadline that will quickly follow the event. Accountable Care Organization (ACO) applications are due by March 30, 2012, which is the second, and potentially final, deadline.

For those of you wondering what this means, CMS’s Accountable Care Organization program is a new federally directed program incorporating new, and varied, pay-for-performance incentives. But what is an ACO?  An ACO is a group of doctors, hospitals and other healthcare providers along with 3^rd party health insurers that work together to deliver high-quality care to their Medicare patients while controlling costs. They are “accountable” for the care, quality, and costs associated with a specific Medicare population.  The concept behind this program is simple - that higher-quality, proactive care where everyone is responsible and will be accordingly rewarded will lead to lower healthcare costs. This is especially true for chronic and high-risk patients, hospital readmissions, and duplicate labs and tests. 

As discussed in InformationWeek’s February issue and what we hear from our clients on a daily basis, one of the key challenges is that organizations must have trusted, timely quality clinical and claims data and aggregate that data across the entire organization – including all their affiliate organizations.  Specifically, during year one, providers will have to report on 33 quality measures. These measures really hit at the heart of the national health crisis as they aim to answer the following questions:

• Are we creating coordinated care environments where patients feel like they are a contributor to the process?
• Are we effective in preventing waste?
• Are we able to help populations of patients achieve wellness in the areas of greatest impact?

In year two, ACO’s must report on eight of these measures and how they improved performance against those measures and lastly, in year three, they have to demonstrate significantly improved performance in 32 measures and report on just one that measures how well patients are functioning.

Despite the looming deadlines, this remains a daunting task and many organizations will continue to struggle to take action without a holistic strategy for managing information and tying this information directly to improvement programs.

Are you forming an ACO?  If so, how are you balancing the formation of an ACO with everything else on the schedule (ICD-10, Meaningful Use, PCMH programs, and more)?

Stay tuned, next week we will be reporting from the HIMSS12 floor and taking a deeper dive into how these challenges can be overcome.

Meaningful Use: Looking Onward to Stage 2

The proposed regulations for Stage 2 Meaningful are now in the final review period before being released this summer. Despite the deadline for achieving Stage 2 requirements being delayed until 2014, successfully attesting will remain a great challenge for providers who are already behind and trying to catch up.

Stage 1 of Meaningful Use is critical to a successful plan as the basic foundation of efficiently and effectively collecting patient data electronically. We should raise our collective glasses to the many providers who have already undertaken initiatives to adopt the first stage of Meaningful Use. For those who have yet to do so, I have a note of caution — Stage 2 will be upon us before we know it, and achieving Stage 1 and becoming comfortable with it is crucial to succeeding in the future stages of Meaningful Use. So, please make haste because time really is running out.

As you are embarking on this journey, there are a few things you should keep in mind:

• Pick a vendor that you will want to stick with long-term
• Address workflows early in the process to make sure that your practice can continue these practices for the long-haul
• Work in teams, instead of putting all the responsibility of data capture on the providers’ shoulders
• Don’t depend solely on traditional training mechanisms

With official timelines and requirements being announced this summer, it is critically important that providers are prepared to continue their momentum regardless of any surprises in Stage 2. The new requirements in Stage 2 are likely to affect more in-depth patient care as physicians will be increasingly expected to utilize their resources to evaluate records and analyze the accumulated data, engage patients, and coordinate care across different care settings.

There is much left to be done, but there is very little time to do it all. Now is the time to leverage all your resources at hand and get ahead before you are left completely behind.

HIMSS12: What Journalists Are Talking About

As we are ramping up for HIMSS12 next week, we thought you might be interested in hearing what one leading reporter has to say about what will be big at this year’s event.

PAN Communications spoke with Don Fluckinger, Features Writer for TechTarget’s SearchHealthIT.com, about what he is expecting to be the focus of HIMSS12 as well as how companies can stand out from the crowd. It comes as no surprise to us at Arcadia Solutions that Don is waiting to hear what the Centers for Medicare and Medicaid Services (CMS) is going to announce in regards to ICD-10 and Meaningful Use Stage 2 requirements. As we have been talking about on our blog, these will have major impacts on healthcare providers’ agendas for the coming year.

To read more, check out the interview here.

To hear more about our take on these important issues, stop by our booth at HIMSS12, #4416. And check out our session with Blackstone Valley Community Health Care while you are at the show. You can find more info here. 

2012 - The Year of the EHR (Part 5)

Last week, we kicked off our 2012 predictions for the world of Health IT. So far, we've discussed:

• The rise of the Health IT Genius Bar.
• Increased hiring of trained Health IT professionals out of college.
• The removal of barriers to Accountable Care.
• Mergers & Acquisitions in the Health IT industry

In Part 5 of our predictions, we'll discuss how HIEs will continue to proliferate beyond the foothold that they gained in 2011.

Health Information Exchange: 2011 saw the beginnings of the NHIN Direct Project gaining a foothold and information exchanges budding on community, state and regional levels. This trend is expected to accelerate in 2012. To maximize the investments in EHRs and related technology and achieve new levels of interaction across the care continuum, HIEs must continue to drive implementations but more importantly, quickly draw healthcare organizations onto the exhanges.

HIEs are the healthcare content superhighway. In the late 1990s and early 2000s, the Internet was expanding rapidly with increasing bandwidth as Internet service providers and thousands of websites were coming online each month. All this content was interesting, but not very interactive (high-resolution pictures, streaming video, gaming and massively multiplying communities like Facebook were all largely missing) and the content had no where to go. The Internet boom suffered from the “last mile” problem or that of getting all the end users affordable bandwidth to their homes and having them connected to the Internet.

Healthcare Information Exchanges are in the same situation as the Internet in the late 1990s. The end users need to be creating meaningful content (trusted EHR data, timely claims data, etc.) and then they must be connected to the exchange to share this useful information. Without a critical mass of end-users (the healthcare organizations, hospitals and health centers) connected and contributing meaningful content, we will suffer the “we built it but nobody came” health exchange of dreams. As we move into 2012, creating meaningful content will remain a key driver, but connecting these end-users and bringing them together to interact in real time is something to look for in 2012.

The real benefit of an EHR system lies in generating, analyzing and, ultimately, using the information to directly improve overall patient care. As we dive into the “Year of the EHR,” it will be critical to track the progress of this technology’s implementation and monitor how it improves patient care across the board.

We hope you enjoyed Arcadia Solution’s predictions for 2012. Throughout the year, we will be looking at many of these more in depth, as well as additional industry news and trends.

2012 - The Year of the EHR (Part 4)

Last week, we kicked off our 2012 predictions for the world of Health IT. So far, we've discussed:

• The rise of the Health IT Genius Bar.
• Increased hiring of trained Health IT professionals out of college.
• The removal of barriers to Accountable Care.

In Part 4 of our predictions, we'll discuss how merger and acquisition activity in the coming year will impact the healthcare and Health IT industries.

Mergers & Acquisitions: In 2011, M&A activity surpassed 2010 total numbers by October. The move toward more cost-effective ambulatory care will continue to accelerate in 2012, putting pressure on hospitals as bed occupancy is reduced. Health systems must have a greater understanding of, and access to, their patient populations throughout the care continuum. The M&A trend will continue as hospital-based systems defend against growing competition and expand primary care referral networks through direct physician practice acquisitions and provider network affiliations. In addition, the high cost of Health IT coupled with the scarcity of trained and experienced personnel will continue to add pressure as smaller networks and single hospital systems struggle to support the growing number of complex initiatives – Meaningful Use, HIPAA compliance, ICD-10, pay-for-performance contracts, CMS Medicare reimbursement changes, Accountable Care formations, etc.

Through merging, economies of scale come directly into play, making the large investments in the needed Health IT systems more palatable. A comprehensive strategy to integrate the various systems already in place and keep these large initiatives progressing properly will be imperative as these systems join together.

Check back Wednesday for the final installment of our 2012 predictions, where we'll discuss how HIEs will continue to proliferate beyond the foothold that they gained in 2011.

2012 - The Year of the EHR (Part 3)

Earlier this week, we kicked off our 2012 predictions for the world of Health IT by discussing the rise of the Health IT Genius Bar. On Wednesday, we brought you back to school to look at the changes and growth in hiring trained Health IT professionals out of college.

Our third prediction for 2012 is how to remove the barriers of accountable care and what this means for the industry as a whole moving forward.

Removing the Barriers of Accountable Care: With the Meaningful Use regulations taking full effect in 2012, we’ll start to see more providers preparing for a pay-for-performance model. Once an EHR implementation has been completed, it’s important that adoption is not only done in full, but is made as easy and efficient as possible. Next year, we’ll see changes in the way doctors are receiving data as well as the frequency. For example, if there are 65 questions on the Meaningful Use assessment that need to be asked for patients who have diabetes but only 10 of these questions are critical, then removing the 55 additional questions will increase the chances of capturing the information needed for doctors to increase the quality of these patients’ care, thus achieving Meaningful Use of their systems.

Earlier this week, we kicked off our 2012 predictions for the world of Health IT by discussing the rise of the Health IT Genius Bar. On Wednesday, we brought you back to school to look at the changes and growth in hiring trained Health IT professionals out of college. Our third prediction for 2012 is how to remove the barriers of accountable care and what this means for the industry as a whole moving forward.

Integrating the adoption process with education and training opportunities to assist with the utilization of the technologies will be critical in 2012. Providers will also begin to make use of real-time reports, making EHR data increasingly actionable. This will provide instant ROI and added incentive to the doctors who are going through the EHR implementation and adoption process. For example, reports will be delivered daily that highlight actions such as, “the following diabetes patients need their glucose levels checked.” Providing these benchmarks will ensure that quality and cost measures are met, and in turn, increasing the bonus levels for the doctor.

Check back Monday for Part 4 of our "2012 - Year of the EHR" predictions, where we'll discuss mergers and acquisitions in the industry.

2012 - The Year of the EHR (Part 2)

Earlier this week, we kicked off our 2012 predictions for the world of Health IT by discussing the rise of the Health IT Genius Bar. Now we are bringing you back to school to look at the changes and growth in hiring trained Health IT professionals out of college.

College and Entry-Level Health IT Hiring: CIOs and IT directors have been forced to contend with crippling shortages of people who have previously worked on EHR deployments, health information exchange (HIE) efforts and other technologies that are involved in the effort to digitize and secure patient data while improving individual care and reducing healthcare costs. It’s important to have employees who understand the technology, privacy, governance and other issues that are involved with EHR deployment, but there is only half the number of qualified employees needed in the work force. In response, the industry and academia must start going in a different direction. We will see more universities offering Health IT courses and companies partnering with these institutions to bring real-world experience to the classrooms and hire and train students right out of college. The University of Texas currently offers a Health IT program and 96 percent of its students were offered jobs directly out of college with higher than average salaries.

Check back Friday for Part 3 of our "2012 - Year of the EHR" predictions, where we'll discuss the removal of barriers to Accountable Care.