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Health Leaders Go Beyond EHRs To Tackle Value-Based Care

Posted on March 30, 2018 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In the broadest sense, EHRs were built to manage patient populations — but largely one patient at a time. As a result, it’s little wonder that they aren’t offering much support for value-based care as is, as a recent report from Sage Growth Partners suggests.

Sage spoke with 100 healthcare executives to find out what they saw as their value-based care capabilities and obstacles. Participants included leaders from a wide range of entities, including an ACO, several large physician practices and a midsize integrated delivery network.

The overall sense Sage seems to have gotten from its research was that while value-based care contracts are beginning to pay off, health execs are finding it difficult support these contacts using the EHRs they have in place. While their EHRs can produce quality reports, most don’t offer data aggregation and analytics, risk stratification, care coordination or tools to foster patient and clinician engagement, the report notes.

To get the capabilities they need for value-based contracting, health organizations are layering population health management solutions on top of their EHRs. Though these additional PHM tools may not be fully mature, health executives told Sage that there already seeing a return on such investments.

This is not necessarily because these organizations aren’t comfortable with their existing EHR. The Sage study found that 65% of respondents were somewhat or highly unlikely to replace their EHR in the next three years.

However, roughly half of the 70% of providers who had EHRs for at least three years also have third-party PHM tools in place as well. Also, 64% of providers said that EHRs haven’t delivered many important value-based contracting tools.

Meanwhile, 60% to 75% of respondents are seeking value-based care solutions outside their EHR platform. And they are liking the results. Forty-six percent of the roughly three-quarters of respondents who were seeing ROI with value-based care felt that their third-party population PHM solution was essential to their success.

Despite their concerns, healthcare organizations may not feel impelled to invest in value-based care tools immediately. Right now, just 5% of respondents said that value-based care accounted for over 50% of their revenues, while 62% said that such contracts represented just 0 to 10% of their revenues. Arguably, while the growth in value-based contracting is continuing apace, it may not be at a tipping point just yet.

Still, traditional EHR vendors may need to do a better job of supporting value-based contracting (not that they’re not trying). The situation may change, but in the near term, health executives are going elsewhere when they look at building their value-based contracting capabilities. It’s hard to predict how this will turn out, but if I were an enterprise EHR vendor, I’d take competition with population health management specialist vendors very seriously.

Pennsylvania Health Orgs Agree to Joint $1 Billion Network Dev Effort

Posted on December 27, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

If the essence of deal-making is putting your money where your mouth is, a new agreement between Pennsylvania healthcare giants fit the description. They’ve certainly bitten off a mouthful.

Health organizations, Penn State Health and Highmark Health, have agreed to make a collective investment of more than $1 billion. That is a pretty big number to swallow, even for two large organizations, though it very well may take even more to develop the kind of network they have in mind.

The two are building out what they describe as a “community-based healthcare network,” which they’re designing to foster collaboration with community doctors and keep care local across its service areas.  Makes sense, though the initial press release doesn’t do much to explain how the two are going to make that happen.

The agreement between Penn State and Highmark includes efforts to support population health, the next step in accepting value-based payment. The investors’ plans include the development of population health management capabilities and the use of analytics to manage chronic conditions. Again, pretty much to be expected these days, though their goals are more likely to actually be met given the money being thrown at the problem.

That being said, one possible aspect of interest to this deal is its inclusion of a regionally-focused academic medical center. Penn State plans to focus its plans around teaching hospital Milton S. Hershey Medical Center, a 548-bed hospital affiliated with more than 1,100 clinicians. In my experience, too few agreements take enough advantage of hospital skills in their zeal to spread their arms around large areas, so involving the Medical Center might offer extra benefits to the agreement.

Highmark Health, for its part, is an ACO which encompasses healthcare business serving almost 50 million consumers cutting across all 50 states.  Clearly, an ACO with national reach has every reason in the world to make this kind of investment.

I don’t know what the demographics of the Penn State market are, but one can assume a few things about them, given the the big bucks the pair are throwing at the deal:

  • That there’s a lot of well-insured consumers in the region, which will help pay for a return on the huge investment the players are making
  • That community doctors are substantially independent, but the two allies are hoping to buy a bunch of practices and solidify their network
  • That prospective participants in the network are lacking the IT tools they need to make value-based schemes work, which is why, in part, the two players need to spend so heavily

I know that ACOs and healthcare systems are already striking deals like this one. If you’re part of a health system hoping to survive the next generation of reimbursement, big budgets are necessary, as are new strategies better adapted to value-based reimbursement.

Still, this is a pretty large deal by just about any measure. If it works out, we might end up with new benchmarks for building better-distributed healthcare networks.

Health Systems, Hospitals Getting Serious About Telemedicine

Posted on December 8, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

In the spring of last year, I wrote up a story about hospitals and health systems and their growing interest in telemedicine. The story included data from a survey on hospitals and telemedicine, which found that health systems averaged 5.51 telemedicine service lines at the time, up almost 20% from 2015.

Given these stats, I was not surprised to see a new press release from Teladoc reporting that the company now supports more than 200 hospitals, a number which represents a 100% growth in such relationships during this year.

If you’re wondering why this has happened, you’ll get more or less the same answer from last year’s study and Teladoc’s news release. In short, it’s all about the outcomes, baby.

When I wrote the story last year, one of the things that stood out for me was that 96% of respondents had said they were planning to roll up telemedicine services because they felt it would improve patient outcomes. While that made sense to me at the time, it seemed more like an aspiration rather than a practical plan.

What made the survey data even more provocative is that “improving financial returns” turned out to be a very low priority for hospitals working on telemedicine programs. At the time, this focus on outcomes rather than direct financial returns surprised me.

Now, about 18 months later, I’m doing the facepalm thing and saying “of course, hospitals want affordable, flexible care delivery options — they’re a great tool for managing population health!” It’s a no-brainer, actually, but I guess my brain wasn’t working at the time.

Now, as far as I know, the assumption that telemedicine can help with PHM and value-based delivery generally has not been rigorously tested. Also, even if the assumption is correct, hospitals are likely to struggle with deploying telemedicine for a while until they develop the most efficient workflows for using it.

Also, while it’s all well and good to say that focusing on outcomes will create ROI as a secondary effect, for some hospitals it will be pretty rough to carry telemedicine infrastructure and staffing costs upfront for a while. After all, if they want to make an impact with telemedicine, they have to make a serious commitment; I’m guessing that most of us would agree that a scattershot approach would get most hospitals nowhere.

Ultimately, though, I think hospitals have it right. Telemedicine is likely to offer health systems and hospitals some amazing options for extending service lines, managing populations more effectively, and yes, improving outcomes.

Predictive Analytics Will Save Hospitals, Not IT Investment

Posted on October 27, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Most hospitals run on very slim operating margins. In fact, not-for-profit hospitals’ mean operating margins fell from 3.4% in fiscal year 2015 to 2.7% in fiscal year 2016, according to Moody’s Investors Service.

To turn this around, many seem to be pinning their hopes on better technology, spending between 25% and 35% of their capital budget on IT infrastructure investment. But that strategy might backfire, suggests an article appearing in the Harvard Business Review.

Author Sanjeev Agrawal, who serves as president of healthcare and chief marketing officer at healthcare predictive analytics company LeanTaaS, argues that throwing more money at IT won’t help hospitals become more profitable. “Healthcare providers can’t keep spending their way out of trouble by investing in more and more infrastructure,” he writes. “Instead, they must optimize the use of the assets currently in place.”

Instead, he suggests, hospitals need to go the way of retail, transportation and airlines, industries which also manage complex operations and work on narrow margins. Those industries have improved their performance by improving their data science capabilities.

“[Hospitals] need to create an operational ‘air traffic control’ for their hospitals — a centralized command-and-control capability that is predictive, learns continually, and uses optimization algorithms and artificial intelligence to deliver prescriptive recommendations throughout the system,” Agrawal says.

Agrawal predicts that hospitals will use predictive analytics to refine their key care-delivery processes, including resource utilization, staff schedules, and patient admits and discharges. If they get it right, they’ll meet many of their goals, including better patient throughput, lower costs and more efficient asset utilization.

For example, he notes, hospitals can optimize OR utilization, which brings in 65% of revenue at most hospitals. Rather than relying on current block-scheduling techniques, which have been proven to be inefficient, hospitals can use predictive analytics and mobile apps to give surgeons more control of OR scheduling.

Another area ripe for process improvements is the emergency department. As Agrawal notes, hospitals can avoid bottlenecks by using analytics to define the most efficient order for ED activities. Not only can this improve hospital finances, it can improve patient satisfaction, he says.

Of course, Agrawal works for a predictive analytics vendor, which makes him more than a little bit biased. But on the other hand, I doubt any of us would disagree that adopting predictive analytics strategies is the next frontier for hospitals.

After all, having spent many billions collectively to implement EMRs, hospitals have created enormous data stores, and few would argue that it’s high time to leverage them. For example, if they want to adopt population health management – and it’s a question of when, not if — they’ve got to use these tools to reduce outcome variations and improve quality of cost across populations. Also, while the deep-pocketed hospitals are doing it first, it seems likely that over time, virtually every hospital will use EMR data to streamline operations as well.

The question is, will vendors like LeanTaaS take a leading role in this transition, or will hospital IT leaders know what they want to do?  At this stage, it’s anyone’s guess.

Geisinger Partners With Pharmas To Improve Diabetes Outcomes

Posted on October 10, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Geisinger has struck a deal with Boehringer Ingelheim to develop a risk-prediction model for three of the most common adverse outcomes from type 2 diabetes. The agreement is on behalf of Boehringer’s diabetes alliance with Eli Lilly and Company.

What makes this partnership interesting is that the players involved in this kind of pharma relationship are usually health plans. For example:

  • In May, UnitedHealth Group’s Optum struck a deal to model reimbursement models in which payment for prescription drugs is better structured to improve outcomes.
  • Earlier this year, Aetna cut a deal with Merck in which the two will use predictive analytics to identify target populations and offer them specialized health and wellness services. The program started by focusing on patients with diabetes and hypertension in the mid-Atlantic US.
  • Another example is the 2015 agreement between Harvard Pilgrim health plan and Amgen, in which the pharma would pay rebates if its cholesterol-control medication Repatha didn’t meet agreed-upon thresholds.

As the two organizations note in their joint press statement, cardiovascular disease is the leading cause of death associated with diabetes, and diabetes is the top cause of kidney failure in the U.S. population. Cardiovascular complications alone cost the U.S. more than $23 billion per year, and roughly 68 percent of deaths in people with type 2 diabetes in the U.S. are caused by cardiovascular disease.

The two partners hope to improve the odds for diabetics by identifying their condition quickly and treating it effectively.

Under the Geisinger/Boehringer agreement, the partners will attempt to predict which adults with type 2 diabetes are most likely to develop kidney failure, undergo hospitalization for heart failure or die from cardiovascular causes.

To improve the health of diabetics, the partners will develop predictive risk models using de-identified EHR data from Geisinger. The goal is to develop more precise treatment pathways for people with type 2 diabetes, and see that the pathways align with quality guidelines.

Though this agreement itself doesn’t have a value-based component, it’s likely that health systems like Geisinger will take up health plans’ strategies for lowering spend on medications, as the systems will soon be on the hook for excess spending.

After all, according to a KPMG survey, value-based contracts are becoming a meaningful percentage of health system revenue. The survey found that while value-based agreements aren’t dominant, 36 percent of respondents generated some of their revenue from value-based payments and 14 percent said the majority of revenue is generated by value-based payments.

In the meantime, partnerships like this one may help to improve outcomes for expensive, prevalent conditions like diabetes, high blood pressure, arthritis and heart disease. Expect to see more health systems strike such agreements in the near future.

Patient Engagement and Collaborative Care with Drex DeFord

Posted on August 7, 2017 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

#Paid content sponsored by Intel.

You don’t see guys like Drex DeFord every day in the health IT world. Rather than following the traditional IT career path, he began his career as a rock ‘n roll disc jockey. He then served as a US Air Force officer for 20 years — where his assignments included service as regional CIO for 12 hospitals across the southern US and CTO for Air Force Health — before focusing on private-sector HIT.

After leaving the Air Force, he served as CIO of Scripps Health, Seattle Children’s Hospital and Steward Health before forming drexio digital health (he describes himself as a “recovering CIO”). Drex is also a board member for a number of companies and was on the HIMSS National board and the Chairman of CHIME.

Given this extensive background in healthcare IT leadership, we wanted to get Drex’s insights into patient engagement and collaborative care. As organizations have shifted to value based reimbursement, this has become a very important topic to understand and implement in an organization. Have you created a culture of collaborative care in your organization? If not, this interview with Drex will shed some light on what you need to do to build that culture.

You can watch the full video interview embedded below or click from this list of topics to skip to the section of the video that interests you most:

What are you doing in your organization to engage patients? How are you using technology to facilitate collaborative care?

Hospital CIOs Still Think Outcomes Improvement Is The Best Use Of EMR Data

Posted on August 4, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Sure, there might be a lot of ways to leverage data found within EMRs, but outcomes improvement is still king. This is one of the standout conclusions from a recently-released survey of CHIME CIOs, sponsored by the trade group and industry vendor LeanTaaS, in which the two asked hospital CIOs five questions about their perceptions about the impact of EMR data use in growing operating margins and revenue.

I don’t know about you, but I wasn’t surprised to read that 24% of respondents felt that improving clinical outcomes was the most effective use of their EMR data. Hey, why else would their organizations have spent so much money on EMRs in the first place?  (Ok, that’s probably a better question than I’ve made it out to be.)

Ten percent of respondents said that increasing operational efficiencies was the best use of EMR data, an idea which is worth exploring further, but the study didn’t offer a whole lot of additional detail on their thought process. Meanwhile, 6% said that lowering readmissions was the most effective use of EMR data, and 2% felt that its highest use was reducing unnecessary admissions. (FWIW, the press release covering the survey suggested that the growth in value-based payment should’ve pushed the “reducing  readmissions” number higher, but I think that’s oversimplifying things.)

In addition to looking at EMR data benefits, the study looked at other factors that had an impact on revenue and margins. For example, respondents said that reducing labor costs (35%) and boosting OR and ED efficiency (27%) would best improve operating margins, followed by 24% who favored optimizing inpatient revenue by increasing access. I think you’d see similar responses from others in the hospital C-suite. After all, it’s hard to argue that labor costs are a big deal.

Meanwhile, 52% of the CIOs said that optimizing equipment use was the best approach for building revenue, followed by optimizing OR use (40%). Forty-five percent of responding CIOs said that OR-related call strategies had the best chance of improving operating margins.

That being said, the CIOs don’t exactly feel free to effect changes on any of these fronts, though their reasons varied.

Fifty-four percent of respondents said that budget limitations the biggest constraint they faced in launching new initiatives, and 33% of respondents said the biggest obstacle was lack of support resources. This was followed by 17% who said that new initiatives were being eclipsed by higher priority projects, 17% said they lacked buy-in from management and 10% who said he lack the infrastructure to pursue new projects.

Are any of these constraints unfamiliar to you, readers? Probably not. Wouldn’t it be nice if we did at least solved these predictable problems and could move on to different stumbling blocks?

We Can’t Afford To Be Vague About Population Health Challenges

Posted on June 19, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Today, I looked over a recent press release from Black Book Research touting its conclusions on the role of EMR vendors in the population health technology market. Buried in the release were some observations by Alan Hutchison, vice president of Connect & Population Health at Epic.

As part of the text, the release observes that “the shift from quantity-based healthcare to quality-based patient-centric care is clearly the impetus” for population health technology demand. This sets up some thoughts from Hutchison.

The Epic exec’s quote rambles a bit, but in summary, he argues that existing systems are geared to tracking units of care under fee-for-service reimbursement schemes, which makes them dinosaurs.

And what’s the solution to this problem? Why, health systems need to invest in new (Epic) technology geared to tracking patients across their path of care. “Single-solution systems and systems built through acquisition [are] less able to effectively understand the total cost of care and where the greatest opportunities are to reduce variation, improve outcomes and lower costs,” Hutchison says.

Yes, I know that press releases generally summarize things in broad terms, but these words are particularly self-serving and empty, mashing together hot air and jargon into an unappetizing patty. Not only that, I see a little bit too much of stating as fact things which are clearly up for grabs.

Let’s break some of these issues down, shall we?

  • First, I call shenanigans on the notion that the shift to “value-based care” means that providers will deliver quality care over quantity. If nothing else, the shifts in our system can’t be described so easily. Yeah, I know, don’t expect much from a press release, but words matter.
  • Second, though I’m not surprised Hutchison made the argument, I challenge the notion that you must invest in entirely new systems to manage population health.
  • Also, nobody is mentioning that while buying a new system to manage pop health data may be cleaner in some respects, it could make it more difficult to integrate existing data. Having to do that undercuts the value of the new system, and may even overshadow those benefits.

I don’t know about you, but I’m pretty tired of reading low-calorie vendor quotes about the misty future of population health technology, particularly when a vendor rep claims to have The Answer.  And I’m done with seeing clichéd generalizations about value-based care pass for insight.

Actually, I get a lot more out of analyses that break down what we *don’t* know about the future of population health management.

I want to know what hasn’t worked in transitioning to value-based reimbursement. I hope to see stories describing how health systems identified their care management weaknesses. And I definitely want to find out what worries senior executives about supporting necessary changes to their care delivery models.

It’s time to admit that we don’t yet know how this population health management thing is going to work and abandon the use of terminally vague generalizations. After all, once we do, we can focus on the answering our toughest questions — and that’s when we’ll begin to make real progress.

Avoiding Financial Losses After EMR Implementation

Posted on April 3, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

While hospitals buy EMRs to improve their operations – both clinically and financially – too often they take a hit before they work out the kinks in their installation.  In fact, healthcare institutions often end up losing up to 5 percent of their gross revenue after EMRs are implemented, according to consultant Erick McKesson.

One typical story comes from Maine Medical Center, which found that patient charges weren’t appearing after its $150 million Epic installation in 2012. These billing errors were one of the reasons the medical center posted a $13.4 million loss in the first six months after the installation, hospital executives reported.

But according to McKesson, managing consultant with Navigant, it’s possible to overcome these problems. In an article for Becker’s Hospital Review, he tells the story of a group of health systems which worked together to avoid such losses. The group worked together to identify the most valuable software features that flagged mischarges or reporting errors. They then identified the five charge program “edits” which had the largest financial impact.

Areas the cooperating health systems considered the most important included:

* Administrative codes

The health systems noted that incorrect administrative codes lead to lagging revenue. That’s particularly the case when there are different codes for the same procedure. Hospitals need to be sure that clinicians use the higher code if appropriate, which can be helped by the right technological fixes.

* Anesthesia

It’s important to monitor your charges when there are two distinct aspects of a single procedure that are charged separately, particularly with anesthesia services. If your audit system flags the absence of the added codes, it can recapture a substantial level of missing revenue.

* CT

Seeing to it that radiology charges are automatically reviewed can ensure that appropriate levels of revenue are generated. For example, in the case of CT exams, it’s important to see that charges are assessed for both the exam and if needed, the use of a contrast agent.

* Emergency Department

It’s not unusual for ED physicians to undercode high-acuity patients. But it’s important to address this issue, as undercoding can result in significant financial consequences.  Not only that, in addition to generating financial losses, undercoding can create problems with performance-based reimbursement contracts. If patients are depicted as less acute than they actually are, payors may expect better outcomes than the patients are likely to have. And that can lead to lower revenue or even significant financial penalties.

* Infusions

Auditing infusion charges can be very helpful in capturing added revenues, given that they are one of the most frequent charges in healthcare. Infusion codes are very complex, including the need to track start and stop times, difficult rules regarding what charges are appropriate during infusions and issues related to “carve out periods.” Auditing systems can help clinicians comply with requirements, including simple-to-create functions which automatically flag missing stop times.

As readers will doubtless know, getting competing health systems to engage in “coopetition” can be tough, even if it helps them improve their operations. But given the need to combat post-EMR lags in revenue, maybe more of them will risk it in the future.

ACOs Not Scaling Well, But Health IT Helps

Posted on March 13, 2017 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

ACOs were billed as the next big thing in healthcare, a model which would create economies of scale and tame rising costs of care. In theory, unifying hospitals and doctors into an overarching entity – and creating shared clinical and financial goals – should improve care and boost efficiency.

Of course, creating them doesn’t come cheap. In fact, creating even a modest ACO typically calls for between $1 million and $3 million in capital investment, according to Michael Deegan, MD, who recently developed a course on ACOs for the University of Texas at Dallas. It also takes 18 to 24 months to launch an ACO, Deegan told an interviewer at UT.

But once all of the Ts have been crossed and the Is dotted, ACOs can meet their stated goals, right? Actually, not so much, though health IT can help things along, according to Indranil Bardham, a colleague of Deegan’s at UT Dallas who serves as professor of information systems.

According to an article in HealthcareITNews, Bardhan recently completed a study on ACO performance which concluded that health IT had a measurable impact on their efficiency. The study, which drew on 2013-2015 data from CMS, reviewed the performance of 400 ACOs.

Among the key takeways Bardhan took from his research was that the larger an ACO was, the more likely it was to be inefficient. This flies in the face of conventional wisdom, which would suggest that bigger is better when it comes to improving efficiency.

On the other hand, health IT use had the effect its champions might hope for, though modest in scope. The study concluded that a 1 percent increase in HIT usage was associated with an 0.5 percent increase in ACO efficiency.

The thing is, these measures represent just a couple of ways to evaluate ACO performance, making it hard to tell just what is working, Bardhan told HIN. “Healthcare, with respect to ACOs, is fascinating because there is not just one single output measure that you are using to compare performance,” he told the magazine’s Bill Siwicki. “…It is difficult to measure the performance of organizations against each other when you have multiple outputs that cannot easily be transformed into a single dollar number.”

This squares with commentary by other ACO researchers, who seem to agree that the whole ACO evaluation process is a bit mysterious. As health policy analyst David Introcaso notes, in a review of ACO-based Medicare Shared Savings Program, CMS isn’t helping either. “While CMS details financial and quality performance results, the agency does not explain, at least publicly, how results, favorable or unfavorable, were achieved.”

Without knowing more about what we should measure, and why – much less what steps helped in achieving their results – it’s too soon to tell what type of health IT should be deployed in ACOs. But looked at more optimistically, once we have a better idea of what ACO success factors are, it seems likely that health IT tools will help execs address them. (For a look at one completely health IT-based ACO concept, see this piece on the Virtual ACO.)