September 26, 2017
ACO Management Tips

Reduce costs while improving patient outcomes. These are the primary goals that a thriving Accountable Care Organization (ACO) should focus on with equal emphasis. This balance is crucial, because without it, focusing only on cost and not the patient, or vice versa, can result in dire consequences for the patient or financial jeopardy for the ACO. How does one accomplish this balance? The key is to pay attention to what you can do to restructure your organization in patient-centered ways that emphasize value-based care over volumes of care.

Previously, we had provided several suggestions for optimizing the success of an ACO. As the number of ACOs across the country are rising and many healthcare providers are signing up, it has become more important than ever before to know how to make an organization run smoothly, both within and between its multiple parts. Here are more things to keep in mind to enhance ACO management and ensure the best possible outcomes.

Know your IT system

What ties things together between different departments, hospitals, and healthcare providers, working together in an ACO, is clear and accurate documentation of all the things that happened during a patient’s care. IT systems such as EHRs are the electronic link – loaded with vital patient information – that enable providers to communicate with one another and facilitate the smooth flow of patient care. It is, therefore, critical to use IT systems to your advantage ­– by optimizing individual EHR use, integrating its use smoothly into patient care workflow at all levels, and enhancing EHR interoperability, so as to transfer and communicate data with ease. To accomplish this, you need to know exactly what is required to make your specific workflow run smoothly and what are the current limitations to your IT system that puts a damper on efficient and effective care. By assessing your needs and current IT pitfalls, you can find ways to tweak the EHR system to your advantage (i.e. customized EHR options through the help of technical vendor support). Additionally, EHR systems need to be integrated successfully across the entire ACO to facilitate smooth data exchange and communication at every step of patient care.

Coordinate data

Just having easy access to correct patient data is not enough to guarantee successful outcomes. How this data is coordinated, organized, interpreted, and ultimately used (both clinically and financially) is also important for a healthy and functioning ACO. Besides clarity and accuracy, patient data needs to be usable and understandable throughout all levels of care. For example, primary care physicians need to be able to easily pull up relevant information and instructions for the continuation of a patient’s care after hospital discharge.

Another example of how coordinating data can benefit an ACO is in the analysis of collected clinical data with financial data (i.e. assessing the clinical benefits from the data and weighing this with financial risks), to evaluate what works or what is necessary to maintain an organization that is efficient in cost while improving patient health.

Coordinated care

For complex or chronic patient cases, coordination of care is key to avoiding readmissions and saving expenses. The teamwork aspect of an ACO is ideally set up for this, as long as communication and task allocation are carefully planned to enable quality care with the efficient use of resources and time. This means that workflow must connect well across the entire ACO – from the ER, acute care hospitals, primary care physicians, and post-acute care. To aid in workflow efficiency, healthcare providers can make use of medical scribes, trained documenters who can relieve physicians from EHR data entry burdens and allow them to concentrate on the medical part of patient care. Additionally, ScribeAmerica Navigators are also available to assist in the continuous care process, both in and out of the hospital, by bridging communication between physician and patient, and maintaining contact with the patient during post-acute or long-term care.

Pay attention to population health

Zeroing in on the specific health risks to the population that you are treating can also help to improve patient outcomes. By understanding the major health risks for a specific population and figuring out how to manage them, healthcare providers within an ACO can better target the use of resources to boost patient outcomes and reduce costs. Data analytics from IT systems, derived from cumulative EHR clinical data, can help to achieve this goal.

Patient engagement

And let’s not forget another crucial element to the care process – the patients themselves. Educating and communicating with patients on how to care for themselves, as well as enforcing continuous follow-up on the quality of their compliance and self-maintenance, not only enables successful outcomes and avoids adverse events, but also empowers the patient to take control of their own health, leading to greater patient satisfaction with how their own care is managed and bonus points for the healthcare organizations that promote these patient-focused initiatives.