Data Collection, Telehealth, and Importance of Primary Care Physicians Get Attention at ACO Coalition Meeting

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Attendees at the ACO and Emerging Healthcare Delivery Coalition meeting held October 16-17, 2014, in Miami, Fla., gained insights to help physicians and accountable care organizations achieve the “triple aim” of better population health, greater patient satisfaction, and lower costs. This initiative of The American Journal of Managed Care has now attracted more than 120 members.

Leonard Fromer, MD, served as moderator of the Miami meeting of the ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care.

We have to redesign the system so we don't burn out the people who are trying to do good work.

More than 50 attendees spent two days here learning how the power of data, better use of staff, and advances like telehealth can free up primary care physicians (PCPs) for their core mission: spending more time with patients whose complex conditions put them at risk for driving up healthcare costs. The ACO and Emerging Healthcare Coalition, a multistakeholder initiative of The American Journal of Managed Care, held its second live meeting October 16-17, 2014, at the Miami Marriott Biscayne Bay.

Through speakers, panel discussions, breakout sessions and networking, a diverse group of participants heard specifics for implementing the “triple aim” of better population health, greater patient satisfaction, and lower healthcare costs. Accountable care organizations, or ACOs, were authorized by the 2010 Patient Protection and Affordable Care Act to achieve these targets in exchange for higher reimbursements from Medicare.

“Feedback from our participants has been tremendous,” said Brian Haug, president of The American Journal of Managed Care. “Our meeting provides a rare opportunity for healthcare leaders from different parts of the system to come together to share ideas. These exchanges are where meaningful change can occur.”

Early on, ACOs have worked to develop interventions for the small group of patients with chronic conditions who account for more than their share of healthcare spending. As speaker Bruce Bagley, MD, FAAFP, president and CEO of TransforMED, said, “Population health is code for identifying the 5-to-7 percent of people who are costing the most money and figuring out what to do.”

Dr. Bagley and other speakers said achieving this requires a re-engineering of the primary care practice, including a concentrated effort to take things off PCPs’ plates, not only to focus their attention on at-risk patients, but also to improve their quality of life. “We have to redesign the system so we don’t burn out the people trying to do good work,” he said.

The Geisinger Model

Keynote speaker Thomas Graf, MD, chief medical officer for Population Health and Longitudinal Care Service Lines, Geisinger Health System, outlined the model that calls for reliance on technology and automation for most wellness care. The more a patient suffers from chronic conditions or comorbidities, the more “hands on” the model becomes.

Geisinger, which operates in central Pennsylvania, offers a variety of settings for patients to receive primary care treatment. Great emphasis is placed on collecting data and teaching office staff to use it, Dr. Graf said, so the PCP has two core functions: handling complex medical decision-making, and maintaining patient relationships.

In the process, Geisinger has not only shown profitable results – Dr. Graf pointed to data showing return on investment is $1.70 for every $1 put into the system – but healthcare measures have also improved sharply over eight years. For example, more patients with diabetes are receiving vaccinations, more are at goal for blood pressure, cholesterol and glycated hemoglobin (A1C), and more are documented non-smokers.

“We’ve moved from providing great care one patient at a time, to great care one patient at a time to an entire population," he said.

Expanding Telehealth

Krista Drobac, executive director of the Alliance for Connected Care, presented the opportunities that could come with expanded use of telehealth, which would involve more appointments by web-based technology. Ms. Drobac said data shows that patients who try telehealth overwhelmingly like it. Regulatory limits on telehealth have curtailed its ability to boost access to care for rural Americans, those with disabilities, or employees who don’t want to lose time from work.

As Ms. Drobac explained, current constraints limit the ability of ACOs to receive Medicare reimbursement for telehealth, even though evidence of its effectiveness justifies payment. Meanwhile, resistance from some state medical associations to changes that would allow physicians to practice outside their home state have prevented telehealth’s growth.

Momentum for telehealth is building with the arrival of “wearable” healthcare technology, which Ms. Drobac said consumers have embraced. “The opportunity is ripe right now,” she said.

About the ACO Coalition
As ACOs and other emerging delivery and payment models evolve and move away from traditional fee-for-service system models toward cost-effective and value-based care, the need to understand how these models will evolve is critical to building long-term strategic solutions. The mission of the ACO Coalition is to bring together a diverse group of key stakeholders, including ACO providers and leaders, payers, IDNs, specialty pharmacy, and pharmaceutical manufacturers to work collaboratively to build value and improve the quality and overall outcomes of patient care. Coalition members share ideas and best practices through live meetings, Web-based interactive sessions and conference calls. Distinguishing features are the Coalition’s access to leading experts and its small workshops that allow creative problem-solving. To learn more, click here.

CONTACT: Nicole Beagin (609) 716-7777 x 131
nbeagin(at)ajmc(dot)com
http://www.ajmc.com

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Mary Caffrey
American Journal of Managed Care
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Nicole Beagin
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