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HHS Proposes New ACO Model – More, and Better Technology Will be Critical

By: | Tags: , , | Comments: 0 | March 20th, 2015

On March 10, 2015, the U.S. Department of Health and Human Services (DHS) via the Center for Medicare Services (CMS), announced a new initiative “the Next Generation Accountable Care Organization (ACO) Model of payment and care delivery”.

The goal of the program is to “encourage quality improvement and care coordination, helping to move our health care system to one that achieves the Department’s goals of better care, smarter spending, and healthier people.”

The release goes on to say-

“The ACOs in the Next Generation ACO Model will take on greater performance risk than ACOs in current models, while also potentially sharing in a greater portion of savings. To support increased risk sharing, ACOs will have a stable, predictable benchmark and flexible payment options that support ACO investments in care improvement infrastructure that provides high quality care to patients.”

“The new ACO model encourages greater coordination and closer care relationships between ACO providers and beneficiaries. ACOs will have a number of tools available to enhance the management of care for their beneficiaries. These tools include rewards to beneficiaries for receiving their care from physicians and professionals participating in their ACOs, coverage of skilled nursing care without prior hospitalization, and modifications to expand the coverage of telehealth and post-discharge home services to support coordinated care at home. The Next Generation ACO Model also supports patient-centered care by providing the opportunity for beneficiaries to confirm a care relationship with ACO providers and to communicate directly with their providers about their care preferences.”

We believe the future of medicine in the U.S. will be in models we are experimenting today and the ACO of today and it’s clearly on the right track. We see technology playing an important role more than ever, not just in the “global” ability to share medical records (EHR), but also with “telehealth”; EHRs that have telehealth incorporated in their systems is extremely beneficial. Additionally, this trend is most promising for three reasons: it would provide quicker access to care givers, expand access and at the same time, reducing cost to provide care.

This new model “encourages greater coordination and closer care relationships between ACO providers/suppliers and beneficiaries,” according to CMS Deputy Administrator for Innovation and Chief Medical Officer Patrick Conway.

The application specifically asks potential participants to share information about their use of electronic health records and their progress in the Meaningful Use incentive program, particularly Stage 2.

We believe that we are just beginning to explore how much technology can encourage better care, better communication and the most valuable aspect, more patient involvement. It is clear to me, that if we in healthcare begin to explore the use of technology that has been around for decades in other industries, we will be able to save lives, reduce cost and limit the amount of resources used.

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