Transforming Health Care Through Accountable Care Organizations

The design and implementation of accountable care structures like ACOs has been a popular mode of transforming healthcare from volume- to value-based healthcare delivery systems. As was oft-quoted in the early stages of ACO development, they are akin to a unicorn—that is, everyone knows what they look like but no one has ever seen one. Now, as ACOs have evolved and have some experience under their belt, the common quote seems to be “when you’ve seen one ACO, you’ve seen one ACO.”

Top Issues Facing Payers on the Journey to Value

We recently held our biannual payer client conference in Orlando, FL, and it was another very productive meeting. Several plans shared their respective progress and challenges as they each journey forward on the path to value. Based on the feedback, my colleague, James Lawson, Vice President, Client Experience, Payment and Population Solutions, shared some key takeaways from the meeting:

Who Will Win at Population Health Management?

Healthcare by transaction is dead. This economic model cannot be sustained. The new frontier involves aligning care providers across the continuum so they can think differently – and act differently. Successful population health management involves the strategic use of data to deliver the right care to the right population at the right time. Instead of managing the health of an individual episodically, providers will be challenged to manage the health of a group of individuals over time. The shift from volume to value requires providers to take on accountability for the total cost of care, the quality of care and the outcomes of care – rather than simply provide services when people are sick.

New Partnerships and New Metrics for Better Population Health

“How do we achieve better population health?”

This is the question on the minds of health care leaders across the country today.

At a recent 3M health care executive conference in Saint Paul, Minnesota, representatives from health plans, hospitals, Medicaid and several non-profit organizations gathered to discuss patient-centered models of care as a way to achieve better population health outcomes.

But attendees didn’t walk away with a clear-cut answer to the question “how do we achieve better population health?” There is no such thing. Instead, they left with affirmation that better population health is going to require (1) new collaborative partnerships and (2) thoughtful consideration of the right metrics for measuring population health.

Live from HFMA: Will data fix our broken health care system?

At the 2014 HFMA conference here in Las Vegas, Dr. Atul Gawande delivered the keynote address and outlined four emerging lessons about U.S. health care:

1. The debate about whether to provide health care coverage to Americans is over.
2. The delivery system is still broken.
3. Understanding the sickest is how we fix our health care system.
4. Success requires making data the most important resource to clinicians and patients for improving care.

So, what does this really mean and what is missing from this picture?

Health Equity: Data and Analytics Are The Great Equalizer

Those in public health believe that everyone is entitled to breathe the same clean air, drink the same safe water, and eat the same uncontaminated food. Public health protects and promotes health for everyone — regardless of race, sex, age, socioeconomic status, whether among rural or urban dwellers, whether the employed or unemployed. The basis for charting progress has been measuring and monitoring health indicators using epidemiologic tools and methodologies that account for variations in the population, such as identifying risk factors for certain conditions and geographic considerations.

But what about equity in access to health care, health information and health security?