Earlier this month, we had the opportunity to participate as sponsors of the Care Coordination Institute’s (CCI) Annual Symposium in Greenville, SC. With a focus on “Providers Leading the Way to Value-Based Healthcare,” the Symposium offered the latest thinking and trends related to care coordination, Accountable Care Organization (ACO) management and insights from top healthcare leaders from across the country.
300 leaders in population health attended the event, and one consistent theme emerged: We have to embrace the new era of change in healthcare. One presenter said, “Changes in healthcare used to be glacial; now changes almost come like an avalanche.”
Leading the way in the transition to value-based care is The Centers for Medicare & Medicaid Services (CMS), which creates policy shaping reimbursement models. Presenters discussed how bundled payments are leading health systems to pivot from focusing on providing “episodic care” to providing “continuous care.”
The challenge? Most health systems still need systems in place to do this. Presenters and panelists emphasized that you can’t have a true continuous care model with just an EHR. You need an integrated system of engagement that is flexible enough to accommodate the rapidly changing healthcare environment, as well as incorporate new payment models to supplement the EHR. This points to the growing value of and critical need for tools like Salesforce Health Cloud, which integrates with an EHR and the V12 ACO App but allows providers to go beyond the record to managing the relationship and delivering more targeted care.
The balancing act of managing reimbursements while maintaining delivery of quality care continues to be top of mind for ACOs. It was noted that only 20% of ACOs are completely successful in meeting their targets, but only 15% incorporate a downside risk component in their member population projections. As the ACO model has gradually become more widely adopted and there is more real-world experience to draw from, we are getting a clearer picture of what successful ACOs do differently. In particular, they are tracking and measuring outcomes so that they have good data for making decisions and can be more comfortable taking risk.
Embracing this change is only the first step. Most attendees agreed health systems will have to overcome several significant barriers to move forward successfully and make the necessary shifts.
During an interactive keynote, we polled participants, asking what they believe is the biggest factor limiting the success of health systems. The top answers:
1. Data quality/availability
2. IT reliability/ease of use
From our standpoint, these are problems with clear solutions. We are encouraged to see new transformative technology and systems stepping up to bridge gaps and facilitate the shift to value-based care. What are your thoughts? Agree with the list? We would love to hear from you at @virsys12.