This year’s Fall Managed Care Forum conference, hosted by the NAMCP, featured a number of presentations and discussions on accountable care organizations (ACOs).
The Centers for Medicare and Medicaid Services
define an ACO as "an organization of healthcare providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.”
Transitioning an organization to an ACO model is a process that takes tremendous leadership from the onset. That is why presenters Mike Meyer, President, Meyer Consulting, and Aran Ron, MD, Partner, Meyer Consulting, began their presentation, “Establishing Successful ACOs and Other Partnerships: A Functional Perspective” by talking about some of the qualities that an ACO leader must possess. Aside from the standard characteristics of being technology savvy and innovative, an ACO leader must be able to align financial and quality incentives. An ACO leader must also be physician-centric, analytical, entrepreneurial, and perhaps most importantly, they must be committed to their vision. This is especially important because it is very likely that there will be some major challenges to implementing the model along the way, and all of those involved must feel that their leader’s vision is one worth working toward.
Next, Mr Meyer and Dr Ron spoke a little bit about the importance of collaboration. For this, an ACO leader must find the right partners and test their motivation. It is important to identify the team members that are responsible for planning and executing the tasks necessary to transition to this model. It is just as important to ensure that those team members have the time, resources, and authority to accomplish the goals set forth. No matter how motivated or responsible team members are, they will not be able to successfully accomplish their tasks without the proper tools.
One case study that was presented during the presentation was that of the AtlantiCare Health System, a two-hospital system with 567 beds and more than 5000 employees and 600 physicians. AtlantiCare recognized the need to develop a clinically integrated organization in collaboration with key partners, and their leadership and dedication to quality while transitioning to an ACO model led to them winning several awards, including the Malcolm Bridge National Quality Award
. The implementation process was successful because AtlantiCare was able to create a shared vision with clear goals that were communicated to all stakeholders. The organization also developed meaningful interpersonal relationships within the network and developed a centralized decision making process to negotiate new payment models. Equally as important, they developed the trust of payers and established contracts that shared the financial benefit of improved outcomes and costs.
There are many complicated business and legal decisions that must be made in order achieve a successful implementation of an ACO model. However, as Meyer and Ron explained in their presentation on Thursday, having the right leadership can make all the difference.