Within an ACO, profitability no longer depends on increasing the volume of care, but refining the efficiency of care throughout the system. That requires new measures and analytics to evaluate clinical and financial performance for entire episodes of care, not just discrete inpatient and outpatient services.
Last week, 3M’s chief medical officer, Sandeep Wadhwa, presented a framework for analytics in accountable care at an industry conference in Chicago. Titled “Measure Twice, Cut Once,” the webcast is free to viewers who register at this link: http://bit.ly/boNXru.
In his framework, Sandeep describes a measurement approach to:
- “Measure once” to determine unit costs for comparison by provider and service line, particularly in the outpatient setting where the volume of services is growing most rapidly.
- “Measure twice” to identify potentially avoidable care, such as preventable hospitalizations and ED visits as well as complications (events that represent patient safety issues and could be unreimbursed expenses).
- “Cut once” to design incentives and clinical interventions.
To top off his presentation, Sandeep summarized the first-year results of the Colorado Accountable Care Collaborative (ACC). This Medicaid program achieved an 8.6% reduction in hospital readmissions and 3.3% decrease in high-cost imaging services, compared to the non-enrolled group. Savings are estimated at $9 to 30 million, a pretty wide window, but still a lot of cost savings even at the lower threshold.
The webcast includes examples and an accountable care analytics checklist. For health systems that are just embarking on accountable care, it is a useful introduction to using longitudinal data to identify performance improvement opportunities.
Kristine Daynes is Product Marketing Manager, Payer Markets, with 3M Health Information Systems.