Originally appeared in Health Data Management on 9/8/15, by Joseph Goedert
Nearly two years ago, leaders of seven independent hospitals in Connecticut started to talk about cooperating with each other. State policy makers were contemplating a provider tax and changes to the Medicaid program and the hospitals realized they needed to work together to protect themselves, which included cooperating with data analytics.
At the time, accountable care and value-based payment were on the near horizon, as well as provider needs to get ready for ACOs, population health management, shared savings and risk-based contacts. “We had to align and increase our scale to get better pricing for group purchases and to have the geographic scale for population health management,” recalls Patrick Charmel, CEO at Griffin Hospital and chair of the Value Care Alliance, which formed in December 2013.
Other hospitals included St. Vincent’s Medical Center, Lawrence+Memorial Hospital, Middlesex Hospital and three that later formed a delivery system—Danbury Hospital, New Milford Hospital and Norwalk Hospital. Under the alliance, the hospitals remain independent but also partners.
Each hospital over time has acquired its own data analytics tools to better under the needs and issues of their organizations and patient populations, and will continue to use the tools for local needs. But now, the seven hospitals are using their scale to create a standard analytics platform to increase capabilities and jointly achieve consistent findings by doing analytics the same way as they seek to better manage at-risk and shared saving contracts, particularly with Aetna, but also with other payers expected in 2016.
The standard platform comes from Arcadia Healthcare Solutions in Burlington, Mass. Dashboards will compare cost, quality and efficiency metrics at aggregate and individual hospital levels to identify and share best practices. The platform includes a central data repository to collect data from alliance members.
Some of the top issues to be analyzed will include member attribution so physicians clearly understand who are in their accountable care patient panels, system leakage to learn the extent to which ACO patients are getting treatment outside the network, performance management, utilization and medical expense, as well as identification and closure of care gaps, prospective risk management and patient engagement.
Hospital members of Value Care Alliance initially looked at 10 analytics vendors and more closely considered four before setting on Arcadia. Having a central repository enables alliance-
wide analysis of metrics. But what separated Arcadia from other vendor suitors was its strong capabilities to extract claims data from payers and, especially, extract clinical data from the hospitals’ electronic health records systems, along with “cool user interfaces,” Charmel says.
The analytics platform now is live, with alliance members developing customized dashboards and Charmel expects they will start seeing actionable data with 30 to 60 days. Value Care Alliance hospitals also have 22,000 employees and dependents among them and are looking to put them in accountable care organizations, so they will have plenty of their own internal analyzes to conduct.
Charmel expects that by the end of 2016, two-thirds of the members’ population health management communities will be in some kind of value-based contractual relationship and moving away from fee-for-service. Consequently, Charmel has a message for other hospitals that may be considering more formal alliances—don’t wait. Competitive juices still bubble to the top; some of the Connecticut hospitals early on questioned the need for a central repository/analytics utility and took a while to understand the value. But accountable care and value-based reimbursement are moving very fast now, Charmel warns. “So, don’t debate too long and you can start sooner.”