They came to praise ACOs

Healthcare leaders flock to Salt Lake City for Health Catalyst's first data analytics conference
By Neil Versel
10:23 AM

"If you're looking for a marker for a bad outcome, you can look at high costs," agreed Geisinger Health System CEO Glenn D. Steele Jr., MD.
Steele said he had an "epiphany" after reading the seminal 2003 Rand Corp. study in the New England Journal of Medicine showing that patients only received 54.9 percent of recommended care for dozens of conditions, including chronic care.

But he said it took Geisinger close to seven years to get financial validation of accountable care. The change happened when cost-conscious Walmart started sending many Pennsylvania employees to Geisinger facilities for cardiology treatment.

Geisinger has been held up as a national example for health reform because it has properly aligned incentives by owning both a health plan and a care network. Still, Steele said that the organization's ACO "sweet spot" is not incentive alignment, but rather data sharing and aggregation.

Minneapolis-based Allina Health System has had similar experiences, according to Chief Clinical Officer Penny Wheeler, MD, who labeled cost a proxy for quality. Wheeler, an OB/GYN, cited Michael Porter of Harvard Business School, who said that quality improvement is the most powerful driver of cost containment. "Quality improvement is a science in itself," Wheeler said.

[See also: Health Catalyst growth finds its niche.]

There was just one problem. "I was trained in delivering care, not in improving it," Wheeler noted. She said that her fellow physicians needed opportunities for professional improvement, so the health system set up the Allina Advanced Training Program, which seeks to ameliorate care through better communications and more collaboration.

Allina doctors had expressed a desire for quality improvement tools, such as how to run an improvement cycle and the knowledge they need to deliver better care. They also wanted leadership development.

Data infrastructure is the "common foundation that has to be in place," Wheeler said.

Allina's data-driven "quality roadmap" includes being a Pioneer ACO and building accountability into commercial payer contracts, according to Wheeler. The organization is one of the 16 remaining Pioneer ACO participants. Among those, about half are making money and the rest are about breaking even; Allina is in the latter category, Wheeler said.

For now, that is just fine. "Our organization went into the Pioneer to learn," Wheeler said. "CMS has been a good partner," she said, while not tipping her hand on whether Allina would re-up next year.

"If we don't do this with CMS, we will do another program that focuses on value," Wheeler said.

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