Here's a task for a CIO: Convince multiple groups with no history of cooperation to share data, overcome massively disparate systems, launch a big data analytics operation and, for an added degree of difficulty, meet a government imposed deadline.
That's the reality facing IT managers and other executives establishing accountable care organizations. The ACO, conceived under the Affordable Care Act, has become an important focus of healthcare reform, as they aim to reduce skyrocketing healthcare costs while boosting care quality.
ACOs Have 'Three Years to Figure It Out'
More than 250 ACOs have launched nationwide since the Department of Health and Human Services (HHS) set the ground rules for their creation in late 2011. The Centers for Medicare and Medicaid Services (CMS), a part of HHS, administers the government's ACO initiative and approves organizations seeking ACO status.
Private payers and large employers also sponsor ACOs separately from the government effort, driving the total number of ACOs to 428, according to Leavitt Partners, a healthcare research company in Salt Lake City.
Key ACO functions include coordinating patient care and improving the health of particular patient populations-particularly those with, or at risk for, chronic diseases such as diabetes. That's where IT comes in. Coordinated care calls for ACO members to share patient data-and tracking population health becomes a big data analytics job.
ACO managers say their organizations require four main technology components: Electronic health records (EHRs), health information exchange (HIE), data warehousing/analytics and patient portals. "You need a strategy around each one of those," says Chuck Podesta, senior vice president and CIO at Fletcher Allen Health Care, an academic medical center based in Burlington, Vt.
Podesta is helping create the IT foundation for OneCare Vermont, a statewide ACO. OneCare Vermont encompasses 13 hospitals, including Fletcher Allen, and 58 independent practices. Podesta said the plan is to get the ACOs technology aspects nailed down this calendar year.
That's a fairly rapid roll out, given that OneCare Vermont launched with CMS approval in January. But the ACO finds itself on a tight schedule: The group needs to hit CMS cost savings targets by 2016 to avoid a financial penalty.
"We have three years to figure it out," Podesta points out. It may be even less, too-Podesta believes an at-risk commercial insurance shared savings program may be in the offing prior to 2016.
Challenge No. 1: Universal EHR Adoption
The clock is ticking for OneCare Vermont and other ACOs. Organizations operating under the CMS Medicare Shared Savings Program will be rewarded if they cut costs while meeting 33 quality standards. An ACO that keep costs below a CMS-established benchmark gets to share a portion of that savings among its participants.
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