April 2012 The Unsettled State of the ACOcontent.hcpro.com/pdf/content/278624.pdf · The two years since healthcare reform became law have witnessed significant changes to the healthcare

April 2012

The Unsettled State of the ACO

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APRIL 2012 | The Unsettled State of the ACO

pAge 3

WWW.HEALTHLEADERSMEDIA.COM/INTELLIGENCE | ©2012 HealthLeaders Media, a division of HCPro, Inc.

Foreword

MINDSTEPS TO AN ACOIn the 1983 book Mindsteps to the Cosmos, English astronomer Gerald Hawkins laid out his concept of “mindsteps”

based on his reflections on the history of scientific thought. He was particularly intrigued by the patterns of

progressive and irreversible changes to scientific paradigms for looking at and understanding the world.

Common characteristics he observed about historic mindsteps were that they were bold, they led to significantly

greater levels of understanding, and the time between each successive mindstep was shorter than its predecessor. In

other words, change was accelerating.

The two years since healthcare reform became law have witnessed significant changes to the healthcare delivery

and financing system by both commercial insurers and governmental payers. Clearly, a major catalyst of these

changes is emergence of Medicare’s accountable care organization programs, the final rule for which was released

last October. The HealthLeaders Media Intelligence Unit has positioned itself at the front lines, tracking the rapidly

evolving views of provider organizations related to ACOs. Its latest survey reveals a significant and rapid shift in

provider organizations’ views about the coming era of accountable care. A mindstep of sorts.

As recently as a few months ago, a HealthLeaders Media survey found only a small number of survey respondents

thought the Medicare ACO model would be successful. HealthLeaders’ latest survey on ACOs finds providers’ views

of ACOs have changed considerably, and are now significantly more favorable. In particular, providers now express

overwhelming optimism with regard to the impact of ACOs in the areas of improving overall efficiency, population

health status, patient experience, and hospital-physician relations. Another significant shift in thinking uncovered

by the survey is that provider organizations are quickly moving from thinking about strategy and policy to thinking

about practical matters such as infrastructure and implementation steps. All in all, we may very well be witnessing

the next mindstep in healthcare delivery as the promise of ACOs begins to unfold—to realize the triple aim of better

coordination of care, better health outcomes, and lower cost.

Marty ManningPresidentAdvocate Physician PartnersOak Brook, ILLead Advisor for this Intelligence Report

http://www.healthleadersmedia.com/INTELLIGENCE/


pAge 4


PATIENT ENGAGEMENT: WHERE MEANINGFUL USE AND THE ACO INTERSECT

All healthcare organizations will be impacted by accountable care, whether that ultimately takes the form of an

ACO or not. Hospitals face multiple challenges, including meaningful use, Medicare or commercial shared risk,

shared payments, reimbursement reforms, the “silver tsunami” of an aging population, quality and population health

imperatives, and ACOs. This year’s HealthLeaders Intelligence Report on ACOs shows hospitals agree the key to

surviving the rapid transformation of healthcare is patient engagement.

The transformation of healthcare, however it presents itself, demands that hospitals mitigate the risk of reduced

payments by finding ways to realize cost savings and discover new sources of revenue, and to improve quality and

outcomes to protect reimbursements. Patient engagement lies at the intersection of meaningful use and the ACO

and, consequently, a hospital’s ability to engage and activate patients and manage population health will dictate its

success or failure as we redraw the health delivery road map.

Patient engagement and activation and population health management are the keys to controlling healthcare costs

related to chronic disease. Together they seek to alter lifestyle choices that impact healthcare utilization, costs, and

outcomes while increasing an individual’s ability and willingness to manage his or her own health. But engaging

patients is not just a matter of creating a patient portal, as required by the proposed rule for meaningful use Stage 2.

Hospitals must understand their patients’ needs, their disease propensities, their demographic and socio-economic

status, and how best to communicate with them if leadership is to develop and implement a successful strategic plan

to engage patients. Once hospitals understand their health constituents and their current and future needs, leaders

can make informed investment decisions and successfully differentiate their patient portal, their services, and their

entire organization from the competition.

Hospitals must engage patients across the continuum of care, from the initial Internet search for a provider or

targeted messaging of needed services throughout the clinical episode to post-discharge continuing care, including

care coordination, prescription renewal reminders, and more.

Patient engagement must also come from within the organization if quality and outcomes are to be improved.

Hospitals need integrated technology infrastructures to engage physicians and providers, improve work flows and

efficiency, and create a personalized, patient-centric and collaborative care environment to engage the patient at all

levels of care.

perspective



pAge 5


To withstand the reinvention of the healthcare landscape, healthcare organizations must reinvent themselves by

taking the time to understand their patients and their needs, learning how to engage them and manage their health,

and equipping them with the tools to manage their own health. Only by understanding their patients and planning

accordingly can hospitals transform generic patient engagement strategies into successful digital health tactics to

survive and thrive in the face of a rapidly changing healthcare industry.

The challenges of reforms are tough, but they will forever change healthcare for the better. The good news is that

technology continues to advance to help overcome those challenges.

Peter Kühn

CEO

MEDSEEK, Birmingham, AL



pAge 6


Table of Contents

Foreword 3

Perspective 4

Methodology 7

RespondentProfile 8

Analysis 9

SurveyResults 14

Organization ACO Status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ACO Structure in the Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Reasons for No ACO Structure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

ACO Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Attributed Number of Members for ACO . . . . . . . . . . . . . . . . . . . . . . . . . 16

ACO Components Planned for Implementation . . . . . . . . . . . . . . . . . . . . 16

Timeline for Operational ACO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Top Drivers for ACO Creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .17

Organization’s Role in the ACO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Potential Disruption Ratings for Various ACO Factors . . . . . . . . . . . . . . 18

Impact of ACOs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Payment Structure for ACO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Annual Attributed Patient Cost Invest in Infrastructure. . . . . . . . . . . . 18

Effect of ACO Structure on Labor Costs . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ACO Strategic and Operational Leader . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

ACO Advantages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

Personal Health Records . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Online Communication Strategy for ACO Development. . . . . . . . . . . . . 20



pAge 7


Methodology

The Accountable Care Organizations Survey was conducted by the HealthLeaders Media Intelligence Unit,

powered by the HealthLeaders Media Council. It is part of a series of monthly Thought Leadership Studies.

In January 2012, an online survey was sent to the HealthLeaders Media Council and select members of the

HealthLeaders audience. A total of 367 completed surveys are included in the analysis. The margin of error for a

sample size of 367 is +/-5.1% at the 95% confidence interval.

About The HealthLeaders Media Intelligence UnitThe HealthLeaders Media Intelligence Unit, a division of HealthLeaders Media, is the premier source for executive healthcare business research. It provides analysis and forecasts through digital platforms, printed publications, custom reports, white papers, conferences, roundtables, peer networking opportunities, and presentations for senior management.

Intelligence Report Editor Margaret dicK tocKnell [email protected]

PublisherMattHeW [email protected]

Editorial Director edWard PreWitt [email protected]

Managing Editor BoB WertZ [email protected]

Intelligence Unit Director ann MacKaY [email protected]

Senior Director of Sales Northeast/Western Regional Sales Manager PaUl Mattioli [email protected]

Media Sales Operations Manager aleX MUllen [email protected]

Copyright ©2012 Healthleaders Media, 5115 Maryland Way, Brentwood, TN 37027 • Opinions expressed are not necessarily those of Healthleaders Media. Mention of products and services does not constitute endorsement. Advice given is general, and readers should consult professional counsel for specific legal, ethical, or clinical questions.

Upcoming Intelligence

Report TopicsED Strategies

Economics of Better Care

Clinical Quality and Safety

ADvISORS FOR THIS INTELLIGENCE REPORTThe following healthcare leaders graciously provided guidance and insight in the creation of this report.

rob SlatteryPresident and CEOIntegrated Solutions Health NetworkJohnson City, TN

Marty ManningPresidentAdvocate Physician PartnersOak Brook, IL

gene lindsey, MdPresident and CEOAtrius HealthNewton, MA



Click to Join Now




pAge 8


Respondent profile

Respondents represent titles from across the various functional areas including senior leaders, operations leaders, clinical leaders,

financial leaders, and information leaders. Over 50% of the respondents have senior leader titles. They are from hospitals, physi-

cian organizations, health systems, health plans/insurers, ancillary, allied providers, and long-term care.

| title

0

10

20

30

40

50

60

5%Financial leaders

2% Information leaders

23% Operations leaders

19% Clinical leaders

51%Senior leaders

Senior Leaders | CEO, Administrator, Chief Operations Officer, Chief Medical Officer, Chief Financial Officer, Executive Dir., Partner, Board Member, Principal Owner, President, Chief of Staff, Chief Information Officer

Clinical Leaders | Chief of Orthopedics, Chief of Radiology, Chief Nursing Officer, Dir. of Ambulatory Services, Dir. of Clinical Services, Dir. of Emergency Services, Dir. of Nursing, Dir. of Rehabilitation Services, Service Line Director, Dir. of Surgical/Perioperative Services, Medical Director, VP Clinical Informatics, VP Clinical Quality, VP Clinical Services, VP Medical Affairs (Physician Mgmt//MD)

Operations Leaders | Chief Compliance Officer, Chief Purchasing Officer, Asst. Administrator, Dir. of Patient Safety, Dir. of Quality, Dir. of Safety, VP/Dir. Compliance, VP/Dir. Human Resources, VP/Dir. Operations/Administration, Other VP

Financial Leaders | VP/Dir. Finance, HIM Director, Director of Case Management, Director of Revenue Cycle

Information Leaders | Chief Medical Information Officer, Chief Technology Officer, VP/Dir. Technology/MIS/IT

Base = 367

Base = 127 (Hospitals)

| number of Beds

1–50 31%

51–199 24%

200–499 30%

500–999 11%

1,000+ 3%

| type of organization

Base = 367

| number of Sites

1–5 28%

6–20 36%

21–49 18%

50+ 18%

Base = 74 (Health systems)

Hospital 35%

Physician org. (MSO, IPA, PHO, clinic) 21%

Health system (IDN/IDS) 20%

Health plan/insurer (HMO/PPO/MCO/PBM) 10%

Ancillary, allied provider 7%

Long-term care/SNF 6%



pAge 9


Although rules for accountable care organizations have been finalized, Pioneer ACOs selected,

and applications for the Medicare Shared Savings Program under way, healthcare leaders remain

uncertain about the value of ACOs to their organization. Many are operationally unprepared

for ACOs and many see financial risk as a potential stumbling block. These are among the key

findings of the 2012 HealthLeaders Media Accountable Care Organizations Survey.

While 11% of respondents say

they are already part of an ACO,

for the rest that are not, just 39%

of healthcare leaders say their

organization plans to become

part of an ACO. Marty Manning,

president of Oak Brook, IL–based

Advocate Physician Partners, says

the results are encouraging because

the ACO concept is so new. “It’s

a little politicized, so for a pretty

conservative industry to embrace it

to that degree, I’d call it a success,”

he says.

Rob Slattery is surprised by what

he considers a low level of ACO

interest, which he notes may reflect a

focus on the more defined Medicare

Shared Savings Program and not so

much on developing a commercial

ACO. “They may have looked at

the Medicare program and decided

that they don’t want to assume that

type of risk,” explains the president

Fewer Indicate Interest, But Those Committed Are On Fast Track By Margaret Dick Tocknell

What Healthcare Leaders Are Saying

“It’s really unclear at this juncture whether the ACO model is viable, and

will heavily depend upon how much CMS funding will be allocated. If the

regulations remain challenging and the funding remains limited, only some

of the largest groups will take the ACO path.”

—CFO for a large physician organization

“It is the right thing to do and should positively impact the overall quality

of patient care. These positives should lead to long-term viability unless the

payers get greedy and lower the targets to unreachable levels.”

—CEO for a large physician organization

“The ACO is yet another form of changing the fundamental concepts of

healthcare delivery today. Regardless of its future, some changes are in

place, and we need to develop more coordinated care processes and better

patient engagement to have a true impact on healthcare costs.”

—Chief medical officer for a health plan

“As long as the docs buy into it, I think that it could work. It is basically

physician capitation without the downstream risk for the doc, but with the

potential for shared savings.”

—Medical director for a health plan/insurer

“We could have great success if our vision and incentives are properly

aligned.”

—CEO for a small hospital

“The ACO concept will be viable if it can quickly begin to cover a majority

of the business. Otherwise, the driver of financial success will continue to

be FFS-based.”

—VP of finance for a health plan/insurer

AnAlySiS



pAge 10


and CEO of Integrated Solutions Health Network in

Johnson City, TN. ISHN is developing an ACO with both

commercial and Medicaid components.

Interest is significantly lower compared to the 2011 ACO

survey when 64% of respondents said they planned to

implement an ACO structure. But here’s the catch: That

survey was conducted before the CMS ACO rules were

even proposed. And 52% of those planning to implement

an ACO didn’t have a target date set for implementation.

This time around, the organizations interested in ACOs

are setting a fast track for having an operational ACO.

Some 11% were up and running in 2011, and another 57% are expected to come on board by 2014.

In terms of the model of the ACO, organizations are equally interested in developing commercial

shared savings (43%) and Medicare shared savings (43%) ACOs.

Organizations that are now or planning to be a part of an ACO are interested for a variety of

reasons: to engage physicians (56%), because more risk is being shifted to providers (51%),

to compete (48%), value-based purchasing (43%), and to provide more resources for clinical

integration (43%).

Slattery cautions that the ultimate focus should be achieving the triple aim of healthcare—

improve the care experience, improve population health, and reduce the cost of care. “If you do

things right, then you’ll have engaged physicians and you’ll be able to value-base services, but

these are only byproducts of achieving the triple aim.”

Gene Lindsey, MD, president and CEO of Atrius Health, an independent physician group with

offices in central and eastern Massachusetts, concurs. He points to value-based purchasing,

which he says isn’t so much a driver as an innovation that allows for cost reduction on the

physician side. “For us the top of the mountain is to care for patients more effectively and to

improve care. That’s what’s driving our ACO.”

AnAlySiS (continued)

“It’s a little politicized, so for a

pretty conservative industry to

embrace it to that degree, I’d

call it a success.”

—Marty Manning, president, Advocate Physician Partners,

Oak Brook, IL



pAge 11


Atrius Health is participating in the Pioneer ACO

program but for several years has been introducing

the components of ACOs—such as care coordination,

electronic medical records, and shared savings—into

its practices. With 800 physicians and about 700,000

patients, Lindsey says Atrius has the scale to support

investments in infrastructure improvements that are key

to ACO development.

Look for ACO components to include care coordinators

or nurse navigators (77%), medical homes (72%), pay

for performance (69%), and clinical pathways (69%).

Manning agrees with the importance of the nurse

navigator but is surprised that only 45% listed disease

registry as a component. “We would argue that disease

registry is where you should start. It’s been our central

tool going back a decade.” He adds that a disease registry is essential to successfully tracking

the care of complex patients, assigning accountability to specific physicians, and measuring

patient outcomes.

Healthcare leaders responded that within their organizations, an ACO will improve healthcare

quality (79%), overall efficiency (70%), population health status (67%), and the patient experience

(66%). They are less enthusiastic about ACOs in terms of payer-provider relations, or payer and

provider margins.

ACOs exist to achieve the triple aim, explains Lindsey, and shouldn’t be constructed with

the idea of securing physician income. “If we’re successful, physician-hospital relations will

improve and so will payer-provider relationships.” He says that Atrius still argues with payers

over reimbursements but that the conversations are more focused on how to reduce total

medical expense.

Money, patient accountability, and physician resistance are identified as potential stumbling

blocks for ACOs. Some 67% of respondents indicate that the financial risk of inadequate


“If you do things right, then

you’ll have engaged physicians

and you’ll be able to value-base

services, but these are only

byproducts of achieving the

triple aim.”

—Rob Slattery, president and CEO, Integrated

Solutions Health Network, Johnson City, TN



pAge 12


payment rates represents a high risk to disrupt the

success of an organization’s ACO. Providers have long

lamented that healthcare reform requires accountability

of everyone except the patient, and 54% of respondents

said patient accountability has a high potential to

disrupt the success of an ACO. Some 53% rate physician

resistance as having a similar effect.

The negative focus on patient accountability bothers

Lindsey. “If we just look at patient accountability, we’re

going to stay in this mess a long time. Just to say ‘It’s not

my fault, it’s the patient’s fault’ isn’t a strategy that’s

going to lead to any resolution of things.”

Slattery says patient accountability is a political landmine. “We’ve created a social system that

supports the behavior that’s counterproductive to health and wellness. Look at obesity.” In that

environment, he says, it’s very difficult to develop benefits and programs that can successfully

incentivize appropriate behaviors and move patients to be more accountable to any care plans

prescribed by their physicians.

Lindsey suggests that the adoption of a more enlightened approach to patient accountability

may help. “We need to try to understand opportunities within the context of a patient’s

experience.” He notes that some cultures, by tradition, consume a very high-carbohydrate diet

that’s associated with a high incidence of diabetes. “Just to tell them to stop eating the way they

are eating—that’s probably not going to be very successful. Three times a day that person has to

make a decision about food that’s contrary to his or her culture.”

Manning agrees that financial risk is a very real concern—especially in the Medicare Shared

Savings Program where an organization may invest millions in infrastructure and wait two years

for a shared savings check.


“If we’re successful, physician-hospital relations will improve and so will payer-provider relationships.”

—Gene Lindsey, MD, president and CEO, Atrius

Health, Newton, MA



pAge 13


Lindsey says when Atrius looked at being a Pioneer ACO,

it expected to support a $10 million investment to care

for 25,000 patients. There are ongoing investments to

consider as well. Among organizations that are or plan to

be part of an ACO, some 54% expect to invest at least 1%

of annual attributed patient costs in infrastructure.

There is general agreement among the survey

respondents that organizations with ACOs will be better

off in terms of cost control, patient outcomes, and

patient engagement. However, respondents generally

see no perceived advantage for ACOs in terms of patient

loyalty or physician satisfaction.

Manning says developing patient loyalty will be more important than expressed in the survey

because, as care coordination efforts mature and payment structures are refined, a lack of patient

loyalty would be a major disadvantage for hospitals. “If you’re doing things that will mean fewer

patients in your beds, then you better be doing things to make them loyal to your system.”

Slattery expects that over time ACOs will provide advantages across the board as organizations

adjust their models to balance the needs of their payers, providers, and patients. “Our focus is

the triple aim. It will provide us with the equilibrium to out-maneuver and out-innovate our

competition and to really enjoy the advantages of an ACO.”

Margaret Dick Tocknell is senior editor for health plans for HealthLeaders Media.


“If you’re doing things that will mean fewer patients in your beds, then you better be doing things to make them loyal to your system.”

—Marty Manning, president, Advocate Physician Partners,

Chicago



pAge 14


Survey Results

FiGURE1| organization aco Status

Q | Is your organization part of an ACO now?

FiGURE2| aco Structure in the Future

Q | Does your organization plan to implement or join an ACO structure in the future?

Base = 325

11%Yes

89% No

Base = 367

39%Yes

61% No

among organizations not part of an aco now



pAge 15


Survey Results (continued)

FiGURE3 | reasons for no aco Structure

Q | What is the main reason you have no plans to implement or join an ACO structure?

0 5 10 15 20 25

25%

20%

14%

9%

7%

3%

23%

Too small to take lead

No strategic interest

Financial disadvantage

Lack of internal resources

Lack of partners

Waiting to be asked

Other

Base = 198

FiGURE4 | aco Model

Q | Which models will be used in your organization’s existing or planned ACO?

0 10 20 30 40 50

43%

43%

27%

20%

16%

Medicare Shared Savings Program (plan to apply)

Commercial Shared Savings

Medicare Advantage/full-risk commercial

Pioneer ACO (selected)

Other, please describe:

Base = 169Multi response

organizations that are or plan to be part of an aco

among organizations with no plans to implement or join an aco



pAge 16



FiGURE6 | aco components Planned for implementation

Q | Which of the following do you plan to implement as part of your ACO?

0 10 20 30 40 50 60 70 80

77%

72%

69%

69%

45%

Care coordinators or nurse navigators

Medical home

Clinical pathways

Pay for performance

Disease registry


FiGURE5| attributed number of Members for aco

Q | Please estimate the attributed number of members your ACO will have when fully functional.

0

10

20

30

40

50

Less than 5,000

5,000- 50,000

50,001- 100,000

100,001-150,000

150,001-200,000

More than 200,000

16%

47%

16%

4% 4%

12%

Base = 169





pAge 17



FiGURE7 | timeline for operational aco

Q | When did or will your organization’s ACO become operational?

Base = 169

FiGURE8 | top drivers for aco creation

Q | What were or are the top drivers for your organization to create an ACO?

0 10 20 30 40 50 60

56%

51%

48%

43%

43%

To engage physicians

Public and private payers are shifting risk to providers

Market competition is driving integration

More resources for clinical integration are needed

Value-based purchasing


0

5

10

15

20

25

30

35

2011 2012 2013 2014 No target dates chosen yet

11%

29%

21%

7%

32%





pAge 18



FiGURE10| Potential disruption ratings for Various aco Factors

Q | Rate these factors for their potential to disrupt the success of your organization’s ACO. Rate on a scale of 1–5, where 1 = Low and 5 = High.

Base = 169

1 (Low)

2 3 45

(High)

The financial risk of inadequate payment rates 4% 8% 21% 42% 25%

Physician resistance 8% 16% 23% 28% 25%

Lack of a common EMR/IT system 17% 14% 21% 30% 18%

The administrative costs of running the ACO 5% 14% 36% 29% 17%

Lack of uniform healthcare quality and/or cost data 9% 16% 27% 32% 16%

Patient accountability 6% 12% 28% 39% 15%

Shortage of primary care physicians 13% 20% 26% 27% 14%

Federal laws that restrict physician self-referral and kickbacks 14% 17% 31% 28% 11%

Payer resistance to new payment structures 15% 20% 28% 29% 9%

Gatekeeper function 6% 29% 41% 22% 2%

FiGURE9 | organization’s role in the aco

Q | What is your organization’s role in the ACO?

0 10 20 30 40 50

43%

18%

18%

13%

8%

Equal partners: We make all key decisions collaboratively with one or more organizations

Leader: We make all key decisions unilaterally, but do not own all the components

Participant: We have a limited contractual relationship, but no real decision-making role

Sole proprietor: We own and operate all the ACO components

Other

Base = 169





pAge 19


Q | Which payment structure will or have you implemented for your organization’s ACO?



FiGURE11| impact of acos

Q | What impact will ACOs have on each of the following at your organization?

Base = 169

Improve Stay the same Worsen

Healthcare quality 79% 20% 2%

Overall efficiency 70% 21% 9%

Population health status 67% 29% 4%

Patient experience 66% 27% 7%

Hospital-physician relations 46% 44% 11%

Payer-provider relations 44% 41% 14%

Provider margin 27% 43% 30%

Payer margin 22% 59% 20%

FiGURE12 | Payment Structure for aco

0 10 20 30 40 50

50%

44%

43%

42%

19%

Pay for performance

Fee-for-service, with both shared gain and shared risk

Negotiated bundled payments

Fee-for-service, with shared savings

Full capitation

Base = 169




pAge 20



FiGURE13 | annual attributed Patient cost invest in infrastructure

Q | What percent of annual attributed patient costs will your ACO invest in infrastructure?

Base = 169

0

5

10

15

20

25

30

35

0%-0.5% 0.6%-1% 1.1%-2% >2%

20%

27%

34%

20%

FiGURE14 | effect of aco Structure on labor costs

Q | What effect do you expect your ACO structure to have on your labor costs?

Base = 169

0

10

20

30

40

50

Major increase Minor increase No effect Minor decrease Major decrease

20%

46%

26%

7%

1%





pAge 21


FiGURE16 | aco advantages

Q | Will organizations that are part of an ACO have advantages over organizations that do not participate? Please assess based on the following criteria.

Base = 367

0

20

40

60

80

100

0.00.20.40.60.81.0

Cost controls Patient outcome Patient engagement

Patient loyalty Physician satisfaction

59%49%

44%

30% 26%

17%23%

27%39%

34%

24% 28% 29% 31% 40%

FiGURE15 | aco Strategic and operational leader

Q | Who in your organization is designated to lead ACO activity, strategically and operationally?

0 10 20 30 40 50 60

57% 11%

11% 14%

9% 11%

8% 18%

8% 20%

4% 15%

3% 10%

CEO

CMO

CFO

VP title

COO

Other C-suite title

Other title

Base = 169

Strategic leadership

Operational leadership


Advantage for ACO No advantage for ACO Not sure




pAge 22


Percent

Provide patients with an online experience that includes information from hospitals, physician practices, and other services

59%

Retain existing patients by offering a patient portal for interactive services such as appointment scheduling and access to medical records

59%

Update our existing website to assist and attract new patients 55%

Leverage mobile technology to patients to promote communication, condition monitoring and management, and health education

50%

Use social media and networking sites such as Twitter and Facebook 38%

Use customer relationship management software for targeted marketing campaigns 29%

We do not yet have a strategy in place 22%

FiGURE18| online communication Strategy for aco development

Q | What is your strategy for using online communications to engage patients as part of your ACO development?

Base = 169

FiGURE17 | Personal Health records

Q | A personal health record should:

0 20 40 60 80 100

83%

79%

12%

7%

Be portable for the patient

Combine patient entered information as well as data from backend clinical systems

Be completely patient entered and maintained information

Be used only within our healthcare organization





Documents

April 2012 The Unsettled State of the ACOcontent.hcpro.com/pdf/content/278624.pdf · The two years since healthcare reform became law have witnessed significant changes to the healthcare