IPA + HIT (aka technology stack) x MSO = ACO

By Gregg A. Masters, MPH

For those not familiar with the ever expanding ‘acronym soup’ we often take for granted inside the healthcare borg:

I/P/A = Independent Practice Association | H/I/T = Health Information Technology | M/S/O = Management Services Organization

Judging by the ‘anemic’ numbers specific to CMS forecasts for participants in the broad brush ‘ACO program’, from Medicare Shared Savings to the more recently added Pioneer class extension, many on the provider side feel somewhat vindicated in their reluctance to dive into round one – at least officially.

Yet, an accumulating series of reports from the front may be causing some reconsideration of the wisdom to watch while others lead (aka risk innovation). The ACO ‘sentiment meter’ is on it’s way UP. For example in the last 24 hours alone (and this doesn’t count some of the more favorable reporting over the last few months) the following piece effectively summarizes the key insight.

Field report: One Pioneer ACO’s 9 early progress point

Courtesy of Massachusetts based Mount Auburn Cambridge Independent Practice Association (MACIPA), one of 32 Pioneer ACOs recognized by CMS, they distill their key operational and development challenges from this perspective:

‘Jeremy Davis, who heads MACIPA’s Project Management team, explained that for his organization the pilot is essentially…’

a natural offshoot of what we already do.

While MACIPA is arguably in an ACO ramp-up phase of their glide path, forward tangible progress is charted via the following 9 program milestones:

• Documenting activities to help create a methodological approach to becoming an ACO, with the ultimate goal of developing a repeatable implementation model.
• Developing a mechanism to identify ACO patients for clinical teams at the point of care, to better coordinate outreach programs such as home healthcare, rehab, and skilled nursing care.
• Delivering letters to all Medicare pilot patients, providing an overview of the program and patient consent model.
• Identifying reporting requirements for the 33 measures CMS will evaluate, which will include a key focus on patient satisfaction measures, as well as screenings and assessments.
• Working with IT infrastructure vendors to create a reporting toolkit for clinical alerts, reporting dashboards, and automated data extraction tools.
• Educating healthcare partners and data suppliers on program goals and securing buy-in for care coordination, including hospital discharge and follow-up procedures.
• Developing additional care management resources to monitor delivery and ensure that patients receive efficient and appropriate hospital care, medication reconciliation on prescribed medications and follow-up visits.
• Developing additional social worker services programs for community-based patient outreach.
• Adding a patient advocate board seat to the MACIPA Board of Directors.

[Read original article here.]

There is much more to share. In a follow-up post I will stitch together a series of posts, articles & reports to back-up my ‘ACO sentiment meter’ claim.

As always, your thoughts or counter argument  is invited.