ACOs Forging the Links

By Ken Terry for HHN Magazine

What hospitals need to know about accountable care; No. 1: Build strong relationships with physicians

Building an accountable care organization is viewed by many hospital executives as the holy grail as they try to figure out how to better manage patient care across the continuum and as they brace for the growth in bundled payments.

Yet, relatively few hospitals and health care systems are ready to form ACOs today. One reason is that their physicians are not ready. Unless a hospital employs most of its staff, ACO success depends on having physician organizations with which to work, and those are still few and far between.

“Hospitals that should be considering an ACO … either have to employ a sufficient number of physicians to make an impact, or they have to have a very well-structured physician hospital organization or independent practice association with a track record of success,” says Thomas Enders III, managing director of the health care group at consulting firm CSC. “If you don’t have that, you can’t deliver on the requirements of an ACO.”

A hospital also needs market clout to draw physicians into an ACO and hold patients there, notes Lisa Bielamowicz, M.D., national physician practice leader of the Advisory Board Co., another consulting company. “If you’re a 200-bed hospital on the edge of a major metropolitan area, it will be difficult to become an ACO, aggregate providers, and manage patient care across the continuum. Because with accountable care, you have to keep patients within the family if you’re going to effectively manage their care,” she says. “Take that same 200-bed organization and plunk it in a small- to medium-sized market, and it could be positioned strongly to aggregate providers and become a successful ACO.”

If your hospital’s competitive situation allows you to consider an ACO strategy, look at your physician alignment and identify the gaps, suggests Wes Champion, senior vice president of Premier Inc., a group purchasing organization that has formed collaboratives to help hospitals start ACOs. You may be able to revive an independent-practice association or a physician-hospital organization that has become ineffective, or work with a multispecialty group that can be the core of an ACO’s physician organization.

Smaller community hospitals might consider joining forces with larger health care systems to form ACOs, Enders says. This may be necessary partly because of the large investment in health information technology that will be required … (Read complete article, here).

Ken Terry is a freelance writer in Sheffield, Mass.