HCOs find risks & opportunities in quest for reduced costs & improv... (cially responsible for the patients of p...)

HCOs find risks & opportunities in quest for reduced costs & improved quality

Date:8/1/2012

cially responsible for the patients of physicians who are not part of the ACO. Health Choice, LLC, in Memphis, TN, had concerns about retrospective patient attribution and administrative complexity.

In contrast, the Atlantic Health System has already begun to see benefits from the formation of its ACO. Author David J. Shulkin, MD, of the Morristown Medical Center and Atlantic Health System ACO, Morristown, NJ, explains that in New Jersey's fragmented health system, patients have a 25% greater chance of staying in an intensive care unit and 75% greater use of specialists than the national average. "New Jersey needed a catalyst for change," Dr. Shulkin notes, "and the MSSP presented us with just that option."

The Atlantic Health ACO consists of four geographically based pods, each consisting of a hospital, physicians, and other community-based organizations in the region. Clinical navigators collaborate with primary care physicians to identify patients with short- and long-term care needs and guide them through planned pathways of care. Sixteen "Centers of Excellence" incorporate multidisciplinary approaches to care management. The Cardiac Success program has achieved 4% to 6% 30-day all-cause readmission rates, compared to the national average of 20-25%, by incorporating protocol-based approaches. "Little by little, New Jersey's fragmented health care system is being replaced with coordination and integration," Dr. Shulkin says.

Ascension Health will use its two Pioneer ACOs, Seton Health Alliance ACO and Genesys Physician Hospital Organization, to teach the rest of its large system about both medical and financial management as well as strategies for engaging physicians around values and shared business goals. Creagh E. Milford, DO, and Timothy G. Ferris, MD, MPH, of Partners HealthCare in Boston, MA, cite key differences from the health care reforms of the 1990s that influenced the decision to participate as a Pioneer ACO, in
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Contact: Rachael Zaleski
mcpmedia@elsevier.com
215-239-3658
Elsevier Health Sciences
Source:Eurekalert

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