Healthcare Reform Stakeholders Summit, Spring 2015 - Episode 10

Coordination of Patient Care in and out of ACOs

Patients who are members of an ACO are not likely to realize it, comments Dennis Scanlon, PhD, Summit moderator. He asks how providers can keep ACO members within the system, avoiding care providers who do not have the same incentives. Ateev Mehrotra, MD, MPH, associate professor of healthcare policy and medicine at Harvard Medical School, and a hospitalist at Beth Israel Deaconess Medical Center, agrees that patients probably do not know what type of system it is or the incentives being used within their ACO.

Coordination of care among any providers (within or outside of the system) improves quality, insists Arthur Vercillo, MD, FACS, a surgeon and regional president of Excellus Blue Cross Blue Shield. This is true of the sickest patients who utilize many services and those members who occasionally use the healthcare system.

Dr Scanlon points out that health information technology is supposed to help in this regard, and legislation (eg, the HITECH Act) and resources have been directed toward improving the utilization of HIT. Yet, he says, “I think critics would say this concept of ‘meaningful use’ has been anything but meaningful in terms of how HIT is being used…all of the investment we’ve made in HIT isn’t sort of moving us in that direction.”

Dr Vercillo notes that the money spent on HIT, the formation of regional health information organizations, “is supposed to reduce redundancy. Empirically, it makes so much sense, but so far, we’re having a hard time proving the ROI is there.”