ACO Coalition Meeting Helps Stakeholders Prepare for 'A Value-Based World'


ACO Coalition Meeting Helps Stakeholders Prepare for “A Value-Based World”

BALTIMORE, Md. — The first gathering of the ACO and Emerging Healthcare Delivery Coalition, an initiative of The American Journal of Managed Care (AJMC), highlighted the importance of collaboration as the nation’s healthcare system moves toward what one speaker called “a value-based world.”

On May 15-16, 2014, over 25 healthcare leaders gathered at the Hyatt Regency to share what has worked so far in moving their integrated healthcare systems, accountable care organizations (ACOs) and other healthcare entities forward in these new delivery models. Through networking, speaker sessions, and small group workshops, participants shared best practices relative to improving transitions of care and patient satisfaction. Sessions also addressed care coordination, medication management and wellness strategies to improve the quality of patient care and reduce overall healthcare costs.

"We're moving to an ACO world, a value-based world," said Kimberly Westrich, MA, director of Health Services Research for the National Pharmaceutical Council. Westrich said changing to a different reimbursement model provides the opportunity to develop a strategic framework, "where lowering costs and raising quality can really be merged together."

A unique feature of the meeting, and the broader ACO Coalition, was the diversity of stakeholders. Bringing ACO providers and leaders, payers, IDNs, specialty pharmacy, retail, group purchasing organizations (GPOs) and pharmaceutical companies together with experts on new healthcare delivery models is central to AJMC’s mission. The Coalition “brings folks together from different perspectives, and allows us to share our thinking and our creativity about finding ways to solve the healthcare problems we are currently facing,” said Coalition Co-chair Anthony Slonim, MD, DrPH, CPE, FACPE, executive vice president and chief medical officer, Barnabas Health System.

Participants had the chance to spend time in small groups working through the real-world challenges of healthcare reform. Among the lessons:

  • ACOs are evolving and stakeholders are “learning as we go.”
  • Collaboration is everyone’s responsibility within the healthcare organization, not just its leaders. Successful healthcare reform will require team-based collaboration of different stakeholders.
  • Consensus is needed on how to measure quality, and achieving this requires strong data management and information sharing.
  • Value-based contracting needs to occur. Payers need to align incentives with the provider community.
  • Pharmacists will be increasingly critical to improving patient outcomes, and collaboration with them is essential. “The pharmacy and pharmacists are integral resources. Data integration and management are key,” said Mike Evans, clinical pharmacist, Geisinger Medical Center, Danville, Pa. “We also know that the care of a pharmacist in the continuum is everywhere in our health system — the acute side, the transitional care side, the ambulatory side, the retail side, and the payer side — we need to have all those actually working together.”

HRA (Healthcare Research & Analytics) surveyed participants before the conference, and those results provided a roadmap for the discussions. Topics of interest for future collaboration include: patient engagement, quality metrics, value-based reimbursement, and health information technology (HIT).

Participants heard presentations at Thursday’s opening session by Slonim and fellow Co-chair Ira Klein, MD, MBA, FACP, senior medical director for Aetna, and took part in a networking reception.

Friday’s presentations included “Leveraging the PCMH Model” by Paige Cooke, assistant director for engagement from the National Committee for Quality Assurance (NCQA), who addressed the connection between strong ACO development and better patient care. “One of the most important concepts that ACOs need to embrace is that the patient-centered medical home (PCMH) model is an evolutionary one,” Cooke said. “It is one that is designed to align with the evolution that is happening in health reform.”

Coalition meetings are just one tool that AJMC offers to guide healthcare’s historic transition. In December, AJMC launched The American Journal of Accountable Care to publish research and commentary specifically related to implementing the Affordable Care Act.

Participants in the ACO and Emerging Healthcare Delivery Coalition have multiple opportunities to continue the dialog and interchanges which include web-based virtual meetings set for July 10 and December 8, 2014, and teleconferences set for June 17, August 18, and November 17, 2014. These programs will begin at 3:30 p.m. EST.

In addition, the ACO and Emerging Healthcare Delivery Coalition will be having their next live meeting October 16-17, 2014, at the Miami Marriott Biscayne Bay.

FOR INFORMATION CONTACT: Nicole Beagin (609) 716-7777 x 131

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