Better Integration to Improve Care Outcomes Highlighted at AJMC's ACO Coalition

Accountable care organizations can improve outcomes and patient experience while reducing costs through integrated care and better use of technology.


SCOTTSDALE, Arizona—Finding the right way to address a patient’s condition before it worsens will ultimately lower the cost of healthcare—and it seems like the healthcare industry is now getting on board.

“You do the right thing, at the right time, at the right dose with the right patient … and the total cost of care goes down, not up,” said Leonard M. Fromer, MD, FAAFP, from Group Practice Forum. “Even if the cost of the treatment might be a lot of money.”

Over the course of 2 days, attendees at the spring live meeting of the ACO & Emerging Healthcare Delivery Coalition, presented by The American Journal of Managed Care, not only heard case studies, panel discussions, and presentations that highlighted how better integration and more coordinated care can improve quality of care while lowering costs, but also shared their own best practices.

Integrating Behavioral Health

With ACOs accountable for both the health and the cost of the population it serves, integrating the behavioral and medical components of health is a necessity.

“Unless you address both the medical and behavioral, you’ll have poor outcomes,” said Roger G. Kathol, MD, CPE, of Cartesian Solutions, Inc, and the University of Minnesota.

Only 25% of people with behavioral health problems are seen in the behavioral health sector, which means that 75% never have access to evidence-based care. The vast majority seen in the primary care setting receive either no treatment or ineffective treatment, he explained, which provides a tremendous opportunity to better address the needs of patients with behavioral health issues seen in the medical setting.

In his workshop, John Santopietro, MD, outlined the virtual care model being used by Carolinas HealthCare System. Instead of co-locating 1 social worker in each practice, the system adapted the model by deconstructing what the provider does and recreating that as a virtual team of providers.

“If you do it that way, you can deploy [the team] much more effectively,” Dr. Santopietro said.

Precision Medicine and ACOs

During his keynote presentation, Dr. Fromer explained that precision medicine is a fundamental piece of the accountable care movement. Oncology is the biggest and earliest adapter, and stakeholders in that space have begun to create nomograms that use an alpha-numeric code to describe something unique about the patient: genetic makeup, tumor makeup, comorbidities, social environment, etc.

“To know which drug will work best first, and not hunt and peck, that’s where you save money— a lot of money,” Dr. Fromer said.

The Future of Healthcare

Clifford Goodman, PhD, of The Lewin Group, moderated a panel discussion between Michael E. Chernew, PhD, of Harvard Medical School; Patricia Salber, MD, MBA, of The Doctor Weighs In; and Bruce Sherman, MD, FCCP, FACOEM, of Buck Consultants, A Xerox Company. They discussed the future of healthcare in the United States, including the sustainability of the Affordable Care Act, the impact of the presidential election on healthcare delivery, employer coverage, and maintaining cost of care in the era of innovation.

“I think that the fundamental challenge that healthcare faces is that innovation is universally considered good, but it’s something we continue to struggle to finance,” Dr. Chernew 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 & Emerging Healthcare Delivery Coalition is to bring together a diverse group of key stakeholders, including ACO providers and leaders, payers, IDNs, retail and specialty pharmacy, academia, national quality organizations, patient advocacy groups, employers, 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 and Web-based interactive sessions. Distinguishing features are the Coalition’s access to leading experts and its small workshops that allow for creative problem-solving. To learn more, click here.

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