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How ACOs can leverage data to improve outcomes

By Elizabeth Johnson, Contributing Writer at Arcadia
Accountable Care Value-Based Care The Schema

Value-based care relies heavily on measurement of costs and outcomes. Those metrics inform a significant amount of decisions about how providers deliver care, so they have to be right, and the faster the better. Accountable Care Organizations (ACOs) that have started to build sophisticated in-house IT infrastructures that deliver data-driven metrics have found that the exercise requires the right people, processes, and technology... and that it is forever ongoing.

Core technology infrastructure — the right devices and right people to use them — combined with robust analytics opens doors for ACOs to transform their current capabilities. Data collection and analysis answers key questions for ACOs such as:

  • Do we have the right mix of internal and external team members?
  • What does our provider mix look like?
  • How are we getting information to those providers so that they can do a better, faster job in order to provide that quality of care and drive down costs?

Arcadia’s Director of Enterprise Solutions Andrea Purjue and Southwestern Health Resources’ CIO Mac Marlow explain how forward-thinking ACOs can leverage data to improve outcomes under alternative payment models in Episode 6 of Season 2 of The Schema, available now. Watch the full episode or catch-up on the complete series.

Below we identify some of the reasons why technology underpins the value-based care model and the importance of continuous innovation.

Fee-for-service alone won’t get us across the finish line where high-quality care is delivered cost-effectively

“We focus on treating the sickest of the sick and that's where a lot of the costs and the burden to the overall system is. If we can reduce those costs at a global level, then we can provide better care for everyone at a more cost effective point…We've also got to look at population health-based strategies. Things like human factors and precision medicine have to work with population health. We have to look at how we build an ecosystem that can really support the entire outlay of care across the whole continuum.”
—Mac Marlo

Given that we are facing generational changes and demographic shifts of a large percentage of our population moving into the later stages of life, holistically, healthcare and the delivery mechanisms that support it are going to have to change. Signs of innovation within the delivery of care models are visible. For example, the home model is growing. More often, instead of having someone have to be in a hospital, there is a push towards hospital at home care.

The widely used fee-for-service model alone, can only take us so far in increasing the level of care the healthcare system can provide at a cost effective point. Alternative payment models such as value-based care are the logical next step in an evolution in the system that takes population health-based strategies into account. The industry is currently finding the balance between the two models that will drive down costs and increase the level of care. And at the same time, it is educating people on the value of alternative models with the goal of driving their wider adoption.

Accountable Care Organizations amplify impact through collaboration

“At the end of the day, it's about humans…because this is health, it affects all of us. It affects our family, our friends, us, in a very direct way. And if we can do more to bring that quality of care to the table, if we can educate not only our peers but our patients so that they're a partner with us in their healthcare, that's really going to help us continue to move forward.”
—Mac Marlow

The shift to value-based care is bigger than any one organization, yet it affects all of us on a very personal, individual level. Because of this, ACOs often come together to share their bodies of knowledge, explore what is working and partner to develop new approaches to care delivery. Technology, data, or systems alone won’t do it, this monumental transition requires everyone to lean in to move the needle together.

In addition, collaboration will give more ACOs the confidence to embrace innovation and experimentation to find iterative, if not transformational, growth. Exploring the benefits of emerging technology like the cloud for example, will enable organizations to go beyond today’s limitations.

Technology helps to create an environment for providers to do a better job

“I don't anticipate the fee-for-service model's really going to ever go away, but adding a new model that questions how we provide healthcare is critical…What we really want to do is create that environment for the providers to do a better job. We want to leverage technology to figure out what those models can really do as far as providing the care value.”
—Mac Marlow

Value-based care developed out of conversations that began in 2006. It’s come a long way in just over 15 years, but healthcare organizations are still figuring things out and understanding where it fits best. When it comes to interventions of care, connectivity, and the data that's required, the ACOs that are doing well marrying clinical and claims data should begin to push the advancement of new technologies in value-based care.

In this next decade of value-based care’s evolution, ACOs will need to focus on exploring the chronic system costs of healthcare and understanding them more deeply as well as identifying ways to drive them down as well as to measure outcomes. To do that, ACOs must have the latest technology systems that can collect the right information and analyze it properly to make sound decisions.