Accountable Care Organization (ACO) Readiness

Recent passage of the Health Reform Act has resulted in a myriad of proposed changes impacting providers (physicians and hospitals), payers and patients.  While specifics related to the changes have yet to be fully defined, it is clear that collaboration, aligned incentives, integration, connectivity and accountability will be hallmark characteristics of the new model(s) of care.  Accountable Care Organizations (ACOs) will be at the core of the proposed changes as the organizational mechanism to facilitate realization of the delivery system overhaul. 

Most organizations are scrambling to understand and determine how best to ready themselves for the inevitable changes.  To that end, Health Directions has experience and expertise in assisting organizations prepare for the anticipated changes and the elements essential for development of successful ACOs.  Specifically we can help you develop:

• Clinical integration strategies — Leveraging our expertise in the areas of, practice management, physician and hospital integration, and health information technology we help our clients design and implement clinical integration strategies across the care continuum that form the foundation for ACO development.
• Primary care networks —  Developing strong, effective, reliable and loyal primary care networks will be essential for successful ACO development.  Health Directions has assisted clients in developing primary care practice acquisition strategies as well as in developing, assessing and improving the revenue cycle management, practice management, physician and hospital integration, and health information technology capabilities of healthcare organizations.
• Hospital/physician alignment strategies —  Aligning the incentives, operations and outcomes of affiliated hospitals and physicians will be another critical success factor in development of successful ACO formation.  Health Directions has significant experience in assisting organizations develop win-win hospital and physician alignment strategy.
• Governance models —  As is the case when undergoing change of any type, leadership and change management are critical.  At Health Directions, we have experience helping our clients establish decision making and management structure.  We draw on our experience in the areas of EMR deployment and health information technology to address the complexities and challenges organizations will face when defining governance structures.
• Patient Centered Medical Homes (PCMHs) —  Formation of Patient Centered Medical Homes can serve as the foundation for ACO development.  As such, Health Directions assists organizations in analyzing and understanding the feasibility of developing PCMHs.  We perform market, financial, and organizational analysis around your current structure and translate this analysis into language that is easily understood within the context of ACO readiness.
• Efficient back office functions —  Streamlined, efficient back office functions will be a requirement for best in class ACO operations.  Health Directions draws on decades of revenue cycle experience to help clients sift through and evaluate the important back office workflows, data collection and reporting requirements of an ACO.
• EMR deployment strategies —  The benefits of an EMR are magnified in the context of an ACO.  In fact, effective and efficient data collection, reporting and monitoring are arguably the most important elements of success in the world of an ACO development.  Health Directions draws on our health information technology and EMR deployment experience to help clients in this critical step towards ACO formation.
• Outcome reporting strategies —  Transparency and reporting of quality and cost data becomes the major driver for managing transition to and ongoing operations of ACOs.  These strategies are dependent upon integration of patient level and claims data in an efficient and effective manner.  Health Directions' experience in development of EMR deployment and Health Information Exchange (HIE) strategies as part of our health information technology competency, uniquely positions us to assist organizations desiring to develop ACO capabilities.
• Leadership training programs —  Implementing and realizing the benefits of an ACO will require new and innovative leadership skills at the hospital/health system, service line, physician practice, and customer service levels.  Understanding the desired skills to compete is one thing; being able to implement these skills is another.  Through its work in revenue cycle, hospital/physician integration, health information technology and practice management Health Directions has developed the requisite skills implement leadership training programs.